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富血小板血浆在非梗阻性无精子症治疗中的作用

Role of Platelet-Rich Plasma in the Management of Non-obstructive Azoospermia.

作者信息

Alharbi Badr

机构信息

Department of Surgery, College of Medicine, Qassim University, Buraydah, SAU.

出版信息

Cureus. 2024 Sep 14;16(9):e69387. doi: 10.7759/cureus.69387. eCollection 2024 Sep.

DOI:10.7759/cureus.69387
PMID:39403643
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11472207/
Abstract

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.

摘要

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。

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本文引用的文献

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Comparison of the therapeutic effect of platelet-rich plasma and injectable platelet-rich fibrin on testicular torsion/detorsion injury in rats.富血小板血浆与可注射富血小板纤维蛋白治疗大鼠睾丸扭转/复位损伤的疗效比较。
Sci Rep. 2024 Aug 5;14(1):18045. doi: 10.1038/s41598-024-67704-4.
2
Effect of autologous platelet-rich plasma on the fertility and quality of cryopreserved buffalo bull semen: a comparative study using OptiXcell® and tris egg yolk extenders.自体富血小板血浆对冷冻水牛公牛精液生育力和质量的影响:OptiXcell®和 tris 卵黄稀释液的比较研究。
BMC Vet Res. 2024 Jun 7;20(1):250. doi: 10.1186/s12917-024-04022-x.
3
Overcoming Male Factor Infertility: A Journey Through Assisted Reproductive Technology With Platelet-Rich Plasma Therapy.克服男性因素不育:通过富含血小板血浆疗法的辅助生殖技术之旅。
Cureus. 2024 Mar 2;16(3):e55378. doi: 10.7759/cureus.55378. eCollection 2024 Mar.
4
Clinical management of nonobstructive azoospermia: An update.非梗阻性无精子症的临床处理:更新。
Int J Urol. 2024 Jan;31(1):17-24. doi: 10.1111/iju.15301. Epub 2023 Sep 22.
5
Efficacy and safety of platelet-rich plasma injections for the treatment of osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.富血小板血浆注射治疗骨关节炎的疗效与安全性:随机对照试验的系统评价与荟萃分析
Front Med (Lausanne). 2023 Jun 27;10:1204144. doi: 10.3389/fmed.2023.1204144. eCollection 2023.
6
Effects of Platelet-Rich Plasma on the Oxymetholone-Induced Testicular Toxicity.富血小板血浆对氧甲氢龙诱导的睾丸毒性的影响。
Diseases. 2023 Jun 9;11(2):84. doi: 10.3390/diseases11020084.
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Cryopreservation of Human Spermatozoa: Functional, Molecular and Clinical Aspects.人类精子的冷冻保存:功能、分子和临床方面。
Int J Mol Sci. 2023 Feb 28;24(5):4656. doi: 10.3390/ijms24054656.
8
Platelets, Protean Cells with All-Around Functions and Multifaceted Pharmacological Applications.血小板:功能全面、药理应用多样的多面手细胞。
Int J Mol Sci. 2023 Feb 26;24(5):4565. doi: 10.3390/ijms24054565.
9
Addition of autologous platelet rich plasma to semen extender enhances cryotolerance and fertilizing capacity of buffalo bull spermatozoa.将自体富血小板血浆添加到精液稀释液中可提高水牛公牛精子的抗冻性和受精能力。
Theriogenology. 2022 Dec;194:104-109. doi: 10.1016/j.theriogenology.2022.09.029. Epub 2022 Oct 4.
10
Improvement of human sperm properties with platelet-rich plasma as a cryoprotectant supplement.富血小板血浆作为冷冻保护剂添加物改善人精子的特性。
Cell Tissue Bank. 2023 Jun;24(2):307-315. doi: 10.1007/s10561-022-10032-6. Epub 2022 Sep 8.