INTRATESTICULAR AUTOLOGOUS PLATELET RICH PLASMA INJECTION IN COUPLES WITH NON-OBSTRUCTIVE AZOOSPERMIA: A NARRATIVE REVIEW.

Abstract

Azoospermia is the most severe form of male infertility presenting around 1% of the male population and 5%-10% of infertile men. Azoospermia is classified into two categories: obstructive azoospermia (OA) and non-obstructive azoospermia (NOA). Currently, micro Testicular Sperm Extraction (mTESE) is still the primary approach especially for cases with NOA. However, there are still some NOA patients in whom sperm can not be yielded even after repeated mTESE attempts. Besides, no definitive alternative treatments exist, prompting ongoing research into new approaches for restoring spermatogenesis in NOA patients. This review focuses on the current literature regarding the possible role of intratesticular autologous platelet rich plasma injection in couples with non-obstructive azoospermia. First, we give an overview of the pathophysiology of azoospermia and the sperm retrieval techniques in azoospermia. Subsequently, we give information about platelet rich plasma (PRP), and briefly discuss the role of PRP on ovaries and endometrium in the light of literature. Finally, we review the current literature on the testicular administration of PRP on animal models and on human. As a conclusion, the findings of the present review suggests that autologous PRP therapy shows promise as a novel approach in male infertility, especially for NOA patients. Nevertheless, additional investigation through randomized controlled trials is necessary to refine the technique and determine its effectiveness to answer the question of whether PRP could significantly improve the second attempt retrieval rate after a failed previous mTESE procedure.