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Comment: It is particularly interesting that the findings of this RCT regarding miscarriage and pre-eclampsia for fresh versus frozen transfers differ from previously reported findings in large retrospective cohort studies that have noted comparable miscarriage rates in fresh versus frozen cycles (Hipp 2016) and increased likelihood of preeclampsia among ART pregnancies conceived in hyperestrogenic states (Martin 2016). Points to the attributes of a randomized trial or perhaps something unique to women with PCOS…

Question 1: Do you think that the blastocyst transfers affected the outcomes of interest? Did the fact that 34 of the 762 assigned fresh cleavage transfer and only 4 of the 746 assigned frozen cleavage transfer opted to have blastocyst rather than cleavage embryos transferred impact the outcomes of interest?

Question 2: Will the findings in this study change your practice patterns?