Platelet-Rich Plasma in Sperm Processing for Assisted Reproductive Technology: Molecular Mechanisms, Clinical...

Area of Science:

• Andrology and Reproductive Medicine
• Biomedical Engineering
• Cellular and Molecular Biology

Background:

• Male infertility affects numerous couples, with poor sperm parameters like motility and mitochondrial function being key challenges.
• Current sperm processing techniques have limitations, especially in severe cases of asthenozoospermia and oligoasthenoteratozoospermia.
• Platelet-rich plasma (PRP), a concentrate of platelets and growth factors, is emerging as a potential adjunctive therapy in reproductive medicine.

Purpose of the Study:

• To systematically review the literature on Platelet-rich Plasma (PRP) applications in sperm processing from 2015-2025.
• To evaluate the efficacy and mechanisms of PRP in improving sperm quality, including motility, mitochondrial function, and DNA integrity.
• To identify limitations and propose recommendations for future research and clinical application of PRP in male infertility.

Main Methods:

• Systematic review of studies including in vitro experiments, clinical trials, animal models, and mechanistic investigations.
• Analysis of PRP concentration-dependent effects on sperm parameters.
• Evaluation of PRP's impact on sperm motility, mitochondrial activity, oxidative stress, and DNA integrity based on application method.

Main Results:

• Optimal benefits observed with 5% PRP, showing 15-30% increase in motility and up to 80% increase in mitochondrial activity.
• Significant reduction in oxidative stress (p < 0.001) and improved DNA integrity with intratesticular PRP administration (~33% reduction in fragmentation).
• PRP mechanisms include antioxidant action, mitochondrial protection via AMPK/NF-κB modulation, and selective sperm preservation, but in vitro application showed limited protection against processing damage.

Conclusions:

• PRP demonstrates biological efficacy and safety for improving sperm quality in male infertility.
• Methodological standardization, including reporting platelet concentration and distinguishing preparation types, is crucial for reproducibility.
• Further randomized trials focusing on live birth rates and standardized characterization protocols are recommended for clinical integration of PRP.