The Effect of Intratesticular Platelet-Rich Plasma Injection on Sperm Retrieval Rates in Non-Obstructive Azoospermia...

Area of Science:

• Reproductive Medicine and Urology
• Andrology and Male Infertility
• Regenerative Medicine

Background:

• Non-obstructive azoospermia (NOA) presents a significant challenge in male infertility.
• Previous testicular sperm extraction (TESE) failures necessitate exploring novel therapeutic strategies.
• Autologous platelet-rich plasma (PRP) has emerged as a potential regenerative treatment.

Purpose of the Study:

• To evaluate the efficacy of autologous intratesticular platelet-rich plasma (PRP) injection.
• To assess sperm retrieval (SR) rates in males with non-obstructive azoospermia (NOA) undergoing salvage microdissection testicular sperm extraction (mTESE).
• To determine the safety and tolerability of intratesticular PRP in this patient population.

Main Methods:

• An inception cohort of 29 infertile males with prior failed TESE underwent intratesticular PRP injection.
• PRP was prepared using an Arteriocyte Magellan kit and injected into each testicle.
• Salvage microdissection testicular sperm extraction (mTESE) was performed at least 90 days post-injection; serum hormone levels were monitored.

Main Results:

• A sperm retrieval (SR) rate of 16.0% (4/25) was observed in patients undergoing salvage mTESE after PRP injection.
• No significant changes in serum total testosterone (TT) levels were detected post-PRP treatment.
• Successful SR was associated with a higher baseline body mass index (BMI).

Conclusions:

• Autologous intratesticular PRP injection is a technically feasible and well-tolerated procedure with a low complication rate.
• The current study indicates a low sperm retrieval rate following PRP treatment in NOA patients undergoing salvage mTESE.
• Further robust scientific evidence is required to establish the definitive efficacy of PRP in improving sperm retrieval outcomes in NOA.