Alharbi Badr
Department of Surgery, College of Medicine, Qassim University, Buraydah, SAU.
Cureus. 2024 Sep 14;16(9):e69387. doi: 10.7759/cureus.69387. eCollection 2024 Sep.
Non-obstructive azoospermia (NOA) is a common cause of infertility in males, which is characterized by the absence of sperm in the ejaculate, resulting from impaired spermatogenesis. The primary therapeutic approaches for the management of NOA include testicular sperm extraction, varicocelectomy in case of clinical varicoceles, and hormonal manipulation. While traditional treatments are found to have a limited role in the management of NOA, recent studies have explored the potential of platelet-rich plasma (PRP) as a safer and promising therapeutic option. Autologous PRP preparations are derived from the patient's blood and comprise growth factors and cytokines, promoting tissue repair and regeneration. PRP has a wide range of applications in the medical field, including managing infertility in males and females. This literature review aimed to evaluate the existing evidence on the efficacy and safety of PRP in the management of NOA. After a thorough review of relevant data from observational and experimental studies, the findings of this study suggested that PRP may positively influence spermatogenesis, sperm quality, DNA integrity, and sperm retrieval during assisted reproductive procedures. Further research is needed to establish the optimal PRP preparation, administration method, and long-term benefits. The newer studies shall include a diverse patient population and employ long-term follow-up to assess the durability of any positive effects of PRP treatment. The growing body of evidence regarding the therapeutic potential for NOA in humans offers greater opportunities for men seeking fertility treatment, informing clinical practice, and optimizing the use of PRP.
非梗阻性无精子症(NOA)是男性不育的常见原因,其特征是射精中无精子,由精子发生受损所致。NOA治疗的主要方法包括睾丸精子提取、临床精索静脉曲张时的精索静脉结扎术以及激素调控。虽然传统治疗在NOA管理中的作用有限,但最近的研究探索了富血小板血浆(PRP)作为一种更安全且有前景的治疗选择的潜力。自体PRP制剂源自患者血液,包含生长因子和细胞因子,可促进组织修复和再生。PRP在医学领域有广泛应用,包括治疗男性和女性不育症。这篇文献综述旨在评估PRP治疗NOA的疗效和安全性的现有证据。在对观察性和实验性研究的相关数据进行全面审查后,本研究结果表明,PRP可能对精子发生、精子质量、DNA完整性以及辅助生殖过程中的精子获取产生积极影响。需要进一步研究以确定最佳的PRP制剂、给药方法和长期益处。新的研究应纳入多样化的患者群体并进行长期随访,以评估PRP治疗任何积极效果的持久性。关于PRP对人类NOA治疗潜力的证据越来越多,为寻求生育治疗的男性提供了更多机会,为临床实践提供了参考,并优化了PRP的使用。