The Efficacy of Platelet-rich Plasma (PRP) Addition in Human Ejaculated Sperm: A Systematic Review and Meta-analysis
Main Article Content
Abstract
To systematically review and meta-analyze existing data from many clinical trials to assess any enhancements in the quality of human ejaculated sperm after PRP treatment. Materials and methods: A literature search was conducted in The Cochrane Library, Google Scholar, and PubMed Library up to November 2022 and then followed the guidelines of Prisma Checklist 2020. The eligible studies included in this meta-analysis must be clinical trials comparing human ejaculated sperm with PRP treatment and without any additional PRP. The assessed outcomes were analyzed quantitatively and qualitatively. Results:There were ninety-three studies retrieved. After excluding inappropriate publications, four studies were eventually included in the meta-analysis (n=319). There were varied PRP intervention methods across publications, but all of them used PRP 2%. By using random-effects models, we found that there was an improvement of the progressive sperm in groups with PRP treatment (MD=18.79; 95%-CI 13.71, 23.87; I2=78%; τ2=21.67; p<0.01). Sperm concentration and morphology were not included in the meta-analysis, but it was described descriptively that both improved after PRP treatment. All articles included in this analysis have low bias risks. Conclusion: After PRP treatment, there is an improvement in sperm progressivity, suggesting the enhanced quality of human ejaculated sperm. Although beneficial in improving sperm motility, strong evidence for further study will be necessary.
Downloads
Article Details
References
Borght MV, Wyns C. Fertility and infertility: Definition and epidemiology. Clinical Biochemistry. 2018;62:2-10. https://doi.org/10.1016/j.clinbiochem.2018.03.012
Angelee J, Chiuman L, Ginting CN, Halim B. Role of Platelet-Rich Plasma to Sperm Quality in Male Partners Undergoing Infertility Treatment. IEEE International Conference on Health, Instrumentation & Measurement, and Natural Sciences (InHeNce). 2021. https://doi.org/10.1109/InHeNce52833.2021.9537240
Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA. Platelet-rich plasma: From basic science to clinical applications. Am J Sports Med. 2009;37(11): 2259-2272. https://doi.org/10.1177/0363546509349921
Jain NK and Gulati M. Platelet-rich plasma: a healing virtuoso. Blood Research. 2016;51(1): 3–5. https://doi.org/10.5045/br.2016.51.1.3
Marques LF, Stessuk T, Camargo ICC, Junior NS, dos Santos L, Ribeiro-Paes JT. Platelet-rich plasma (PRP): methodological aspects and clinical applications. Platelets. 2015;26(2):101–113. http://doi.org/10.3109/09537104.2014.881991
Al-Nasser R, Khrait Z, Jamali S. The Effectiveness of Autologous Platelet-Rich Plasma (PRP) in the Terapy of Infertile Men with Non-Abstractive Azoospermia. J Reprod Med Gynecol Obstet. 2018;3: 011. https://doi.org/10.24966/RMGO-2574/100011
Somova O, Ivanova H, Sotnyk N, Kovalenko K, Feskova I. The effectiveness of the platelet-rich plasma treatment of men with severe oligoasthenoteratozoospermia. Abstracts of the 37th Annual Meeting of the ESHRE. 2021. P-050 https://doi.org/10.1093/humrep/deab127.041
Gudelci T, Cakiroglu Y, Yuceturk A, Yuksel SB, Karaosmanoglu O, et al. The Effect of Intratesticular Injection of Autologous Platelet Rich Plasma (PRP) on Sperm Retrieval Rates and IVF Outcomes in Men With Non-obstructive Azoospermia and History of Failed Testicular Sperm Extraction. Fertility and Sterility. 2021. P-538 https://doi.org/10.1016/j.fertnstert.2021.07.893
Gudelci T, Cakiroglu Y, Yuceturk A, Yazicioglu C, Karaosmanoglu O, 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. P-432 https://doi.org/10.1016/j.fertnstert.2022.08.805
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 https://doi.org/10.1016/j.fertnstert.2022.08.805
Mirzaei J, Movahedin M, Halvaei I. Plasma-Rich in Growth Factors Ameliorates Detrimental Effects of Cryopreservation on Human Sperm: A Prospective Study. Cell J. 2022; 24(6): 330-336. https://doi.org/10.22074/cellj.2022.8119
Nabavinia MS, Yari A, Gashemi-Esmailabad S, Gholoobi A, Gholizadeh L, et al. Improvement of human sperm properties with platelet rich plasma as a cryoprotectant supplement. Cell Tissue Bank. 2022. https://doi.org/10.1007/s10561-022-10032-6
Cochrane Collaboration (https://www.cochrane.org/)
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372. https://doi.org/10.1136/bmj.n71
PRISMA statement guidelines and checklist (http://www.prisma-statement.org/)
Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:I4898. https://doi.org/10.1136/bmj.l4898
Abduljabar WA, Mossa HAL, Abood M S. Beneficial Role of Platelet –Rich Plasma (PRP) combined with Glass Wool Filtration for Best Recovery of Spermatozoa in Infertile Men. European Journal of Clinical Medicine. 2021;2(5):11-13. http://dx.doi.org/10.24018/ejclinicmed.2021.2.5.125
Ma’alla NJ, Rahim AI, Al-Kawaz UM. Comparison of Results of Semen Parameters Prepared by Swim-up Technique Between the Effect of Adding Autologous Platelet-Rich Plasma, Ready to Use Medium, and Phosphate Buffer Saline to the Human Semen. Iraqi Journal Of Embryos And Infertility Researches. 2021;11(1):13-22. http://doi.org/10.28969/IJEIR.v11.i1.r2.21
Hamdan DA, Rahim AI, Al-Kawaz UM. Studying the effect of adding autologous platelet rich plasma (PRP) to the human semen on the sperm motility. Annals of the Romanian Society for Cell Biology. 2021;25(6):17583-17589 http://annalsofrscb.ro/index.php/journal/article/view/9088
Lestari SW, Lestari SH, Pujianto DA. Sperm quality after swim up and density gradient centrifugation sperm preparation with supplementation of alpha lipoic acid (ALA): A preliminary study. AIP Conference Proceedings. 2018;1933:030015-1-030015-6. http://annalsofrscb.ro/index.php/journal/article/view/9088
Marck RE, Gardien KLM, Vlig M, Breederveld RS, Middelkoop E. Growth factor quantification of platelet-rich plasma in burn patients compared to matched healthy volunteers. Int. J. Mol. Sci. 2019;20(2):288. http://doi.org/10.3390/ijms20020288
Dehghani F, Sotoude N, Bordbar H, Panjeshahin MR, Karbalay-Doust S. The use of platelet-rich plasma (PRP) to improve structural impairment of rat testis induced by busulfan. Platelets. 2018;1-8. https://doi.org/10.1080/09537104.2018.1478400
Sharda A, Flaumenhaft R. The life cycle of platelet granules. F1000Research. 2018;7:236. https://doi.org/10.12688/f1000research.13283.1
Scridon A. Platelets and Their Role in Hemostasis and Thrombosis—From Physiology to Pathophysiology and Therapeutic Implications. International Journal of Molecular Sciences. 2022;23(21):12772. https://doi.org/10.3390/ijms232112772
Chakraborty S, Saha S. Understanding sperm motility mechanisms and the implication of sperm surface molecules in promoting motility. Middle East Fertility Society Journal. 2022;27(4). https://doi.org/10.1186/s43043-022-00094-7
Steegborn C. Structure, mechanism, and regulation of soluble adenylyl cyclases - similarities and differences to transmembrane adenylyl cyclases. Biochim Biophys Acta. 2014;1842:2535–2547. https://doi.org/10.1016/j.bbadis.2014.08.012
Bhoumik A, Saha S, Majumder GC, Dungdung SR. Optimum calcium concentration: a crucial factor in regulating sperm motility in vitro. Cell Biochem Biophys. 2014;70:1177–1183. https://doi.org/10.1007/s12013-014-0038-x
Saucedo L, Sobarzo C, Brukman NG, Guidobaldi HA, Lustig L, Giojalas LC, et al. Involvement of fibroblast growth factor 2 (FGF2) and its receptors in the regulation of mouse sperm physiology. Reproduction. 2018;156(2):163–172. http://doi.org/10.1530/REP-18-0133
Saucedo L, Buffa GN, Rosso M, Guillardoy T, Gongora A, et al. Fibroblast Growth Factor Receptors (FGFRs) in Human Sperm: Expression, Functionality and Involvement in Motility Regulation. Plos One. 2015;10(5). https://doi.org/10.1371/journal.pone.0127297
Attar E, Balcik P, Bulgurcuoglu S, Ozsait B, Serdaroglu H, Hekim N. The Role of Vascular Endothelial Growth Factor (VEGF) on Sperm Motility and Survival in Endometriosis. Fertility and Sterility. 2005;84(1):139. https://doi.org/10.1016/j.fertnstert.2005.07.506
Sharkey DJ, Tremellen KP, Briggs NE, Dekker GA, and Robertson SA. Seminal plasma transforming growth factor-β, activin A and follistatin fluctuate within men over time. Human Reproduction. 2016;31(10):2183-2191. https://doi.org/10.1093/humrep/dew185
Hermilasari RD, Moh Rizal D, Wirohadidjojo YW. Potential Mechanism of Platelet-rich Plasma Treatment on Testicular Problems Related to Diabetes Mellitus. Prague Medical Report. 2023;124(4):344-358. https://doi.org/10.14712/23362936.2023.27
Roudebush W, Purnell ET. Platelet-activating factor content in human spermatozoa and pregnancy outcome. Fertil Steril. 2000;74(2):257-60. https://doi.org/10.1016/s0015-0282(00)00646-4
Chen J, Tan W. Platelet activation and immune response in diabetic microangiopathy. Clinica Chimica Acta. 2020;507:242-247. https://doi.org/10.1016/j.cca.2020.04.042
Roudebush WE, Wild MD, Maguire EH. Expression of the platelet-activating factor receptor in human spermatozoa: differences in messenger ribonucleic acid content and protein distribution between normal and abnormal spermatozoa. Fertility and Sterility. 2000;73(5):967-971. https://doi.org/10.1016/s0015-0282(00)00485-4
Wu H, Gao J, Wang X, Leung TY, Duan YG, et al. Platelet-activating factor induces acrosome reaction via the activation of extracellular signal-regulated kinase in human spermatozoa. Andrologia. 2020;00:e13565. https://doi.org/10.1016/s0015-0282(00)00485-4
Zhao J, Dong X, Hu X, Long Z, Wang L et al. Zinc levels in seminal plasma and their correlation with male infertility: A systematic review and meta-analysis. Scientific Reports. 2016;6:22386. https://doi.org/10.1038/srep22386
Jimenez-Trejo F, Tapia-Rodrigues M, Cerbon M, Kuhn DM, Manjarrez-Gutierrez G, et al. Evidence of 5-HT components in human sperm: implications for protein tyrosine phosphorylation and the physiology of motility. Reproduction. 2012;144(6): 677–685. https://doi.org/10.1530/REP-12-0145
Bader R, Ibrahim JN, Moussa M, Azoury J, Alaaeddine N. In vitro effect of autologous platelet-rich plasma on H2O2-induced oxidative stress in human spermatozoa. Andrology. 2020;8:191-200. https://doi.org/10.1111/andr.12648
Okonofua FE, Ntoimo LFC, Omonkhua A, Ayodeji O, Olafusi C, et al. Causes and Risk Factors for Male Infertility: A Scoping Review of Published Studies. Int J Gen Med. 2022;15:5985–5997. https://doi.org/10.2147/IJGM.S363959