The role and implication of platelet-rich plasma in male factor infertility: A systematic review of human studies

BackgroundCryopreservation causes sperm injury and the success of surgical sperm retrieval (SSR) for azoospermic men is just over half depending on the cause of azoospermia. The role of autologous platelet-rich plasma (PRP) in male factor infertility (MFI) is unclear.ObjectiveTo conduct a systematic review of the role of PRP in MFI focusing on human studies.MethodsA systematic review was conducted using PubMed with reference to the PRISMA 2020 statement. The risk of bias assessment of the included studies was performed using the JBI assessment checklists. Outcome measures included the effects of PRP on cryopreservation, semen parameters, and SSR.ResultsThe search retrieved 119 articles and 10 met the pre-defined PICO criteria. These included 7 prospective studies, 1 randomised-controlled study, 1 retrospective study, and 1 case report. PRP appeared to improve semen parameters, decrease DNA fragmentation, improve recovery of cryopreserved sperm, and improve SSR rate. A case report demonstrated successful intracytoplasmic sperm injection and pregnancy following incubation of semen with PRP in a patient with previous failed IVF attempts.Discussion and conclusionThis is the first systematic review summarising data from human studies on the role of PRP in MFI. The inclusion criteria and outcomes of across studies varied, limiting the ability to conduct a quantitative analysis. Data from early studies on PRP in MFI are promising. However, there is a lack of well-designed clinical studies on this topic, and further research is needed to replicate current findings and evaluate the potential benefits of PRP in MFI.