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In a mildly irreverent way, the FRMC over three conference days will againattempt to link evolving basic science with cutting-edge clinical practice, inthe process facilitating translational connections between bench and clinic.The purpose is to demonstrate to clinicians what is possible and to informbasic scientists about what is needed. The intent is not to dream about the future , but to demonstrate what is possible now ! The FRMC frequently premieres new paradigms and encourages the audienceto think differently . As new findings are reported in basic sciences and clinicaljournals, the conference content, therefore, evolves over the preceding year byfollowing the most current scientific and clinical developments. Sincereproduction contains information about everything important, - life, death,regeneration, immune tolerance, etc., the earliest stages of embryodevelopment never fall out of fashion. Worldwide declines in IVF live birth ratessince 2013 have still not attracted the attention they deserve. Never bashful inaddressing controversies, this represents a strong reason to raise the issueagain at FRMC 2023 . It does not take special insights to conclude that thosedeclines must relate to changes in IVF practice patterns over the last decade,- in the USA increases in utilization of preimplantation genetic testing foraneuploidy (PGT-A) likely being the most consequential. What leads to theintroduction of so many unvalidated “add-ons” to IVF, is, of course, also worthpondering, as many not only have failed to improve IVF outcomes but, incertain sub-populations, actually harm outcomes. With precision medicineincreasingly replacing evidence-based medicine as medicine’s most favored“slogan,” the FRMC , of course, will jump right into the subject, even though theconcept of IVF treatment individualization has been promoted by thisconference since its inception. The FMRC , therefore, more than ever before, promises a very memorable visitto NYC at one of the most beautiful times of the year to visit this city.