摘要目的:探讨培养液提前1 d低氧环境（5%氧气浓度）和高氧环境（20%氧气浓度）平衡对体外受精（ in vitro fertilization，IVF）或卵胞质内单精子注射（intracytoplasmic sperm injection，ICSI）胚胎发育潜能及妊娠结局的影响。 方法:回顾性队列研究分析了邢台不孕不育专科医院生殖医学中心2018年8月至2019年9月期间行IVF和ICSI患者的881个周期的临床资料。培养液提前1 d配制置于培养箱中平衡，根据培养箱氧气浓度分成低氧平衡组（5%氧气浓度）和高氧平衡组（20%氧气浓度）。比较两种授精方式下不同培养液平衡环境对胚胎发育和妊娠结局的影响。结果:不同授精方式下低氧平衡组和高氧平衡组间的获卵数、受精率、双原核（two pronucleus，2PN）卵裂率及可用胚胎率等差异均无统计学意义（均 P>0.05）。第3日可用胚胎率行IVF患者中组间差异无统计学意义。行ICSI患者中低氧平衡组显著高于高氧平衡组［68.52%（664/969）比64.42%（795/1234）， P=0.043］；不同授精方式下低氧平衡组的囊胚形成率均显著高于高氧平衡组［IVF：44.99%（808/1796）比41.45%（841/2029）， P=0.027；ICSI：42.00%（307/731）比34.95%（317/907）， P=0.004］。低氧平衡组的移植胚胎数目均显著低于高氧平衡组［IVF：（1.87±0.34）枚比（1.96±0.21）枚， P=0.001；ICSI：（1.79±0.41）枚比（1.94±0.23）枚， P=0.002］。种植率、临床妊娠率及活产率组间差异均无统计学意义（均 P>0.05）。logistic回归分析结果显示液体平衡环境与活产率显著相关（ OR=0.238，95% CI=0.139~0.409， P<0.001）。 结论:培养液提前1 d低氧平衡（5%氧气浓度）能够提高IVF和ICSI受精胚胎的发育潜能，显著提高活产率，ICSI效果较IVF明显，但确切结果仍需大样本的随机对照研究进一步证实。

abstractsObjective:To investigate the development of embryos cultured and pregnancy outcomes after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) under medium incubated with low oxygen (5% oxygen concentration) and high oxygen (20% oxygen concentration) one day in advance. Methods:We retrospectively analyzed the data of 881 IVF/ICSI cycles from August 2018 to September 2019 in the Reproductive Medicine Center of Xingtai Infertility Specialist Hospital. The culture medium was prepared one day in advance and placed in an incubator for balance. According to the oxygen concentration in the incubator, it was divided into low oxygen balance group (5% oxygen concentration) and high oxygen balance group (20% oxygen concentration). The effects of two different medium balanced environments on embryonic development and pregnancy outcomes under two insemination methods were compared.Results:The number of oocytes retrieved, the fertilization rate, the two pronucleus (2PN) cleavage rate and the vailable embryo rate were not significantly different between the two groups of IVF and ICSI (all P>0.05). There was no significant difference on day 3 (D3) available embryo rate between the two groups of IVF, but it was significantly higher in the low oxygen balance group than in the high oxygen balance group of ICSI [68.52% (664/969) vs. 64.42% (795/1234), P=0.043]. The available blastocyst rate of the low oxygen balance group were significantly higher than that in the high oxygen balance group in IVF and ICSI [IVF: 44.99% (808/1796) vs. 41.45% (841/2029), P=0.027; ICSI: 42.00% (307/731) vs. 34.95% (317/907), P=0.004]. The number of transferred embryos in the low oxygen balance group was significantly lower than that in the high oxygen balance group in IVF and ICSI (IVF: 1.87±0.34 vs. 1.96±0.21, P=0.001; ICSI: 1.79±0.41 vs. 1.94±0.23, P=0.002). The implantation rate, the clinical pregnancy rate, and the live birth rate were not significantly different between the two groups of IVF and ICSI. Logistic regression showed that liquid balance environment was related to live birth rate ( OR=0.238, 95% CI=0.139-0.409, P<0.001). Conclusion:Compared with the high oxygen, medium incubated in the low oxygen (5% O 2 concentration) can enhance the developmental potential of embryos, significantly enhance live birth rate, and ICSI is more effective than IVF. But the exact results still need to be confirmed by a large sample of randomized controlled studies.