The Effect of Intratesticular Injection of Autologous Platelet Rich Plasma (PRP) on Sperm Retrieval Rates and IVF Outcomes in Men with Non-Obstructive Azoospermia and History of Failed Testicular Sperm Extraction

Abstract

Abstract In this study, we aimed to assess the impact of intratesticular injection of autologous platelet-rich plasma (PRP) on sperm retrieval rates and in vitro fertilization outcomes in men with non-obstructive azoospermia (NOA) who had previously undergone at least one unsuccessful microscopic testicular sperm extraction (micro-TESE) procedure. We divided participants into two groups: Group 1 with one prior failed micro-TESE procedure and Group 2 with two or more previous failures. Three months after the PRP injection, micro-TESE procedure was done on the day of egg retrieval. Sperm was successfully retrieved in 22 out of 80 of patients (27.5%) in Group 1, and 9 out of 55 patients (16.4%) in Group 2. Fertilization rates after intracytoplasmic sperm injection was 86.4% (19/22) in Group 1 and 100% (9/9) in Group 2. In Group 1, 31.81% of cases (7/22) and, in Group 2, 22.22 % of cases (2/9) resulted in live births. The use of autologous PRP in men with the diagnose of NOA who had a history of failed micro-TESE is a promising new experimental method in the field of male infertility. Nevertheless, additional investigation through randomized controlled trials is necessary to refine the technique and determine its effectiveness.