Therapeutic use of platelet-rich plasma for the treatment of male infertility

Uso terapéutico del plasma rico en plaquetas para el tratamiento de la esterilidad masculina

Platelet-Rich Plasma (PRP) is a regenerative therapy that has gained interest in recent years, being the subject of various studies and applications. In the field of human reproduction specifically, there are growth factors (GFs) present in PRP that have shown an impact on sperm quality and function. The main objective of this article is to conduct a literature review on the use of PRP for the treatment of male infertility. To achieve this, a bibliographic search of articles and reviews in scientific journals about the possible use of PRP for the treatment of male factor published between 2018 and 2023 has been carried out. Nine publications were identified, proposing the application of PRP in the following areas: sperm cryopreservation, oxidative stress, culture of spermatogonial stem cells, and secretory azoospermia. According to the literature, supplementing the cryopreservation medium with PRP improves sperm parameters, and samples incubated with PRP show an increase in their antioxidant capacity. Finally, PRP can increase the proliferation and vitality of spermatogonial stem cells and sperm recovery in cases of non-obstructive azoospermia. PRP shows therapeutic potential in various aspects of the male factor. Further research with a larger sample size is needed to define both its protocols and its clinical efficacy.

Resumen

La terapia regenerativa conocida como Plasma Rico en Plaquetas (PRP) ha captado una creciente atención en los últimos años, siendo objeto de diversos estudios y aplicaciones. En el campo de la reproducción humana en concreto, hay factores de crecimiento (FCs) presentes en el PRP que han mostrado impacto en la calidad y función espermática. El objetivo principal de este artículo es realizar una revisión bibliográfica sobre el uso del PRP para el tratamiento de la esterilidad masculina, para ello se ha llevado a cabo una búsqueda bibliográfica de artículos y revisiones en revistas científicas acerca del posible uso del PRP para el tratamiento del factor masculino publicados entre los años 2018 y 2023. Se identificaron 9 publicaciones, que proponían la aplicación del PRP en las siguientes áreas: la criopreservación espermática, el estrés oxidativo, el cultivo de células madre espermatogoniales y la azoospermia secretora. Según la bibliografía, suplementando el medio de criopreservación con PRP conseguimos mejorar los parámetros espermáticos y las muestras incubadas con PRP presentan un aumento en su capacidad antioxidante. Por último, el PRP es capaz de incrementar la proliferación y vitalidad de las células madre espermatogoniales y la recuperación espermática en casos de azoospermia no obstructiva. El PRP muestra un potencial terapéutico en varios aspectos del factor masculino. Se requieren más estudios con un mayor tamaño de muestra para establecer tanto los procedimientos de obtención y uso como la efectividad de esta terapia.

Platelet-rich plasma; Male infertility; Sperm cryopreservation; Oxidative stress; Spermatogonial cell culture

Palabras Clave

Plasma rico en plaquetas; Infertilidad masculina; Criopreservación de esperma; Estrés oxidativo; Cultivo de células madre espermatogoniales

[1] Alves R, Grimalt R. A review of platelet-rich plasma: history, biology, mechanism of action, and classification. Skin Appendage Disorders. 2018; 4: 18–24.

[2] Sharara F I, Lelea L L, Rahman S, Klebanoff J S, Moawad G N. A narrative review of platelet-rich plasma (PRP) in reproductive medicine. Journal of Assisted Reproduction and Genetics. 2021; 38: 1003–1012.

[3] Epifanova M V, Gvasalia B R, Durashov M A, Artemenko S A. Platelet-rich plasma therapy for male sexual dysfunction: myth or reality? Sexual Medicine Reviews. 2020; 8: 106–113.

[4] Yan B, Zhang Y, Tian S, Hu R, Wu B. Effect of autologous platelet-rich plasma on human sperm quality during cryopreservation. Cryobiology. 2021; 98: 12–16.

[5] Martínez-Martínez A, Ruiz-Santiago F, García-Espinosa J. Platelet-rich plasma: myth or reality? Radiology. 2018; 60: 465–475.

[6] Everts P, Onishi K, Jayaram P, Lana J F, Mautner K. Platelet-rich plasma: new performance understandings and therapeutic considerations in 2020. International Journal of Molecular Sciences. 2020; 21: 7794.

[7] Dhurat R, Sukesh M. Principles and methods of preparation of platelet-rich plasma: a review and author’s perspective. Journal of Cutaneous and Aesthetic Surgery. 2014; 7: 189–197.

[8] Magalon J, Chateau A L, Bertrand B, Louis M L, Silvestre A, Giraudo L, et al. DEPA classification: a proposal for standardizing PRP use and a retrospective application of available devices. BMJ Open Sport and Exercise Medicine. 2016; 2: e000060.

[9] Dehghani F, Sotoude N, Bordbar H, Panjeshahin M R, Karbalay-Doust S. The use of platelet-rich plasma (PRP) to improve structural impairment of rat testis induced by busulfan. Platelets. 2019; 30: 513–520.

[10] Hernández-Corredor L, León-Restrepo S, Bustamante-Cano J, Báez-Sandoval G, Jaramillo X. Effect of the incorporation of plasma rich of platelets on the spermatozoa physiology of ram semen. Journal of Dairy, Veterinary & Animal Research. 2020; 9: 34–38.

[11] Susilowati S, Triana I N, Malik A. The effects of insulin-like growth factor I (IGF-I) complex from seminal plasma on capacitation, membrane integrity and DNA fragmentation in goat spermatozoa. Asian Pacific Journal of Reproduction. 2015; 4: 208–211.

[12] Khadivi F, Koruji M, Akbari M, Jabari A, Talebi A, Ashouri Movassagh S, et al. Application of platelet-rich plasma (PRP) improves self-renewal of human spermatogonial stem cells in two-dimensional and three-dimensional culture systems. Acta Histochemica. 2020; 122: 151627.

[13] Nabavinia M S, Yari A, Ghasemi-Esmailabad S, Gholoobi A, Gholizadeh L, Nabi A, et al. Improvement of human sperm properties with platelet-rich plasma as a cryoprotectant supplement. Cell and Tissue Banking. 2023; 24: 307–315.

[14] El-Sherbiny H R, Abdelnaby E A, Samir H, Fathi M. Addition of autologous platelet rich plasma to semen extender enhances cryotolerance and fertilizing capacity of buffalo bull spermatozoa. Theriogenology. 2022; 194: 104–109.

[15] Gómez-Torres M J, Medrano L, Romero A, Fernández-Colom P J, Aizpurúa J. Effectiveness of human spermatozoa biomarkers as indicators of structural damage during cryopreservation. Cryobiology. 2017; 78: 90–94.

[16] Almadaly E A, Ibrahim I M, Salama M S, Ashour M A, Sahwan F M, El-Kon I I, et al. Effect of platelet-rich plasma (PRP) on post-thaw quality, kinematics and in vivo fertility of fertile and subfertile buffalo (Bubalus bubalis) spermatozoa. Veterinary Research Communications. 2023; 47: 61–72.

[17] Abdulla A K, Rebai T, Al-Delemi D H J. Protective effects of autologous platelet-rich plasma (PRP) on the outcome of cryopreservation in rabbit sperm. Cellular and Molecular Biology. 2022; 68: 113–121.

[18] Bader R, Ibrahim J N, Moussa M, Mourad A, Azoury J, Azoury, et al. In vitro effect of autologous platelet-rich plasma on H2O2-induced oxidative stress in human spermatozoa. Andrology. 2020; 8: 191–200.

[19] Cho C L, Agarwal A. Role of sperm DNA fragmentation in male factor infertility: a systematic review. Arab Journal of Urology. 2017; 16: 21–34.

[20] Gudelci T, Cakiroglu Y, Yuceturk A, Yazicioglu C, Karaosmanoglu O, Kopuk S Y, et al. Men with non-obstructive azoospermia and history of failed (mTESE) microdissection testicular sperm extraction: outcomes after intratesticular injection of platelet rich plasma (PRP). Fertility and Sterility. 2022; 118: e289.

[21] Ulhe SM, Choudhary N, Shrivastava J, Dutta S, Dakre SM, More A. Overcoming male factor infertility: a journey through assisted reproductive technology with platelet-rich plasma therapy. Cureus. 2024; 16: e55378.