cfDNA is detectable on days 3 and 5, but more accurate on day 5. Although our data suggest moderate concordance rates, PGT-A with the use of cfDNA must be further optimized before clinical implementation.

Readmission to the SICU significantly increases the risk of death beyond that predicted by the APACHE II or SAPS scores alone. Higher APACHE II and SAPS scores upon discharge from the SICU and longer SICU LOS are associated with an increased incidence of readmission to the SICU on the same hospital stay. These results may be used to optimize the timing of SICU discharge and reduce the chance of readmission to intensive care.

Neonates born from commissioned embryos and carried by gestational surrogates have increased adverse perinatal outcomes, including preterm birth, low birth weight, hypertension, maternal gestational diabetes, and placenta previa, compared with singletons conceived spontaneously and carried by the same woman. Our data suggest that assisted reproductive procedures may potentially affect embryo quality and that its negative impact can not be overcome even with a proven healthy uterine environment.

A lower MC at the blastocyst stage was associated with euploid status and blastocyst formation, indicating better embryo quality compared to those with a higher MC. Higher MC in aneuploid and arrested embryos may be explained by slower cell division or degradation of genomic DNA over time. Blastulation timing may be helpful for selection of higher quality embryos. Combining blastulation timing and MC along with morphologic grading and euploid status may offer a new direction in embryo selection.

For women with PCOS, the stair-step clomiphene protocol is associated with decreased time to ovulation and increased ovulation rates at higher doses when compared with the traditional protocol.

The first live birth after IVF was achieved in a purely natural cycle. Because early attempts at IVF were associated with low efficiency, ovarian stimulation was added to achieve a greater margin for error in oocyte retrieval, fertilization, and thus, overall pregnancy success. As technology improved, the intuitive appeal of the natural cycle led investigators to once again attempt IVF without antecedent gonadotropin stimulation. Triggering of ovulation with hCG was added to allow for accurate scheduling of oocyte retrieval and thus increased oocyte yield. When GnRH antagonists became available, premature ovulations could be prevented, albeit at the cost of adding some form of ovarian stimulation to continue follicle development until ovulation triggering. This type of cycle came to be known as the "modified natural cycle." These modified natural IVF cycles are associated with decreased medication costs, they produce acceptable pregnancy rates, and they may be particularly appropriate for patients at increased risk of ovarian hyperstimulation syndrome, poor responders, and those wishing to avoid supernumerary embryo production.

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