The Effect of Intratesticular Platelet-Rich Plasma Injection on Sperm Retrieval Rates in Non-Obstructive Azoospermia Male after Failed Testicular Sperm Extraction: An Inception Cohort

Purpose

While sperm recovery was demonstrated in males who failed prior testicular sperm extractions, the role and efficacy of autologous platelet-rich plasma (PRP) in males with non-obstructive azoospermia (NOA) undergoing salvage microdissection testicular sperm extraction (mTESE) still need to be determined. Materials and Methods: Patients with a history of NOA and at least one previous failed surgical sperm extraction were invited to participate in this study. We analyzed data from an inception cohort of 29 infertile males from January 2023 to February 2025. The primary endpoint was sperm retrieval (SR) rate at surgery. An Arteriocyte Magellan kit was used for the PRP preparation. After injecting local anesthesia as a spermatic cord block, up to 1.5 mL of the PRP mixture was injected into each testicle. After at least 90 days post-injection, microscopic-assisted testicular sperm extraction was performed. We assessed changes in serum hormone levels—specifically circulating total testosterone (TT), follicle-stimulating hormone, luteinizing hormone, and estradiol—following intratesticular PRP injection.