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Outcomes were modeled using the generalized estimating equation approach. Data are from 25387 donor oocyte cycles, in which 14289 were fresh and 11098 were frozen ETs. A GBO was 27% more likely in fresh ETs (26.3%) compared to frozen (20.9%) (adjusted risk ratio 1.27; 95% confidence interval (CI) 1.21-1.35; P  0.001). Overall, fresh transfer was more likely to result in a live birth (55.7% versus 39.5%; adjusted risk ratio 1.21; 95% CI 1.18-1.26; P  0.001). Among singleton births, there was no difference in g