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All transfers were performed according to the methods previously described by Mansour.14 The embryos that were not transferred were cryopreserved or discarded according to their morphology. Pregnancy determinations The biochemical pregnancy was assessed 14 days after the embryo transfer by measuring the hCG-beta subunit in blood. The clinical pregnancy was determined by Quinapyramine transvaginal ultrasonography to detect gestational sacs and fetal heartbeats at approximately 21 and 28 days after transfer, respectively. Statistical analysis Statistical analysis was carried out using the statistic package Stata 10 (StataCorp, College Station, TX, USA). Data are represented as mean �� SD. Group comparisons were made using the ��2 test and Student��s t-test. It was considered a statistically significant difference when P selleck kinase inhibitor study and control groups, respectively. One hundred and twenty-seven from the study group and 544 oocytes from the control groups were injected. There were a total of 78.7% and 76.1% of cleaved oocytes at day 3/total injected oocytes, in the study and control groups, respectively. There was no difference in the number of media cells and the quality of embryo at day 3 between groups. The patients of the study group significantly received more embryos compared to those patients from the control group (2.63 �� 0.58 versus 1.93 �� 0.25; P GDC-0449 mouse 7.7% and 20.9%; P = not significant) (Fig. 2). For the study group, one and two gestational sacs were observed in 8 (61.5%) and 3 (23.1%) patients, respectively. For the control group, one and two gestational sacs were observed in 38 (88.4%) and 5 (11.6%), respectively. These percentages were similar in both evaluated groups. Additionally, three gestational sacs were observed in two patients from the study group (15.4%) (Table 2). Figure 2 PRs, IRs, and MRs. Discussion The INVO procedure consists of utilizing the vaginal cavity environment for the oocyte fertilization and embryo development.