Protective effect of exosomes derived from platelet-rich plasma during human sperm cryopreservation

Fertility preservation is a critical aspect of improving human life quality. Sperm cryopreservation is highly recommended for men at risk of infertility; however, it can have detrimental effects on sperm quality. In this study, we evaluate the effects of platelet-rich plasma (PRP) and PRP-derived exosomes on cryopreservation outcomes in men with asthenoteratozoospermia referred to a public infertility center. The semen samples from 75 men with asthenoteratozoospermia (based on WHO 2020 criteria) were randomly divided into five groups: Control (conventional freezing), Exo/before, Exo/After, PRP/Before, and PRP/After. In all intervention groups, PRP or exosomes were added either 1 h before freezing or 1 h after thawing. Sperm parameters and oxidative stress were evaluated in all samples. Sperm incubation with exosomes before freezing significantly improves motility and lowers DNA fragmentation index (DFI) and oxidative stress compared to the control and other groups. Based on the present study, semen incubation with exosomes for 1 h before freezing not only protects sperm against oxidative stress but also enhances some sperm parameters, such as motility, in men with asthenoteratozoospermia.