Evaluation of the Effectiveness and Outcome of Platelet Rich Plasma(PRP) Intratesticular Local Injection in Infertile Men with Asthenospermia: A Prospective Case Control Study

Abstract

Objective: To assess and evaluate the effectiveness of intratesticular local injection of platelet rich plasma in patient with history of infertility had asthenospermia diagnosed by seminal fluid analysis.

Study Design: Prospective study
Place and Duration of Study: This study was conducted at the Infertility Clinic, Urology Department, Aldiwaniyah Teaching Hospital Iraq from 15th March 2024 to 31st December 2025.

Methods: Two hundred patients with history of infertility their age 25-40 years had asthenospermia confirmed by seminal fluid analysis at where enrolled. Seminal fluid analysis and hormonal evaluation were done in all patients before platelet rich plasma injection and at one, three and six months post injection, the local intratesticular platelet rich plasma were done under sterile condition in all patients. There are two types of outcomes were observed, the primary outcome was sperm motility improvement and the secondary outcomes were the changes that observed in sperm count and morphology and the safety profile of the procedures.

Results: Sperm motility show a significant improvement following platelet rich plasma injection progressive motility increased from 16.3%±4.1 at baseline to 38.9%±4.5 at 6 months (p<0.001), while total motility improved from 27.5%±7.2 to 48.7%±8.1 (p<0.001). Sperm count increased from 19.5±7.3 to 30.2±6.4 million/ml, and normal morphology improved from 4.6%±1.3 to 6.8%±1.9 (p<0.001). Generally, 80% of participates showed significant improvement. The process was safe, and mild temporary complications like scrotal pain 15%, swelling 7.5% and hematoma 2.5%.

Conclusion: Intratesticular platelet rich plasma injection, can be consider as a safe and promising minimally invasive therapy for improving sperm motility and overall semen parameters in men with asthenospermia.