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• W3199393668 abstract "Nonobstructive azoospermia (NOA) is the absence of sperm in the ejaculate resulting from severe deficits in spermatogenesis due to primary testicular dysfunction. NOA is diagnosed in 5-10% of men undergoing infertility work-up. In order to retrieve sperm cells in men with NOA, a number of surgical techniques have been developed, including testicular sperm aspiration (TESA) and conventional or microdissection testicular sperm extraction (cTESE/mTESE). However, effective strategies to obtain spermatozoal cells in men with NOA who fail mTESE procedures are not available. The aim of the current study was to investigate the effect of intratesticular injection of autologous platelet rich plasma (PRP) on sperm retrieval rates and IVF outcomes in men with NOA and a history of at least one previously failed mTESE procedure. Reproductive age men diagnosed with NOA with at least one previous failed mTESE procedure and without genetic or anatomical abnormalities were included in the study. Autologous PRP was prepared from peripheral blood by centrifugation and was injected into the seminiferous tubule or to the interstitial space using a 5 ml syringe. On the third month after the testicular PRP procedure, gonadotropin stimulation was initiated in the female partner on the 2-4th days of menstrual cycle. Sperm extraction was performed with the mTESE procedure coinciding with the egg retrieval day in order to use fresh sperm cells. Results were reported in groups according to the number of previous mTESE procedures (Group 1: with a history of one previous failed mTESE procedure; Group 2: with a history of at least two previous failed mTESE procedures). Fertilization, clinical pregnancy (positive hCG), sustained implantation (>8 weeks), and livebirth rates were followed. A total of 121 men (mean age 35.6 ± 5.2) with a diagnosis of NOA were included in the study. PRP treatment resulted in positive sperm cells in 12 out of 55 men (21.8%) in Group 1 and in 3 out of 36 men (8.3%) in Group 2. After intracytoplasmic sperm injection (ICSI), fertilization was achieved in 10/12 (83.3%) of the couples in group 1, and 2/3 (66.6%) of the couples in group 2. Among the women who underwent embryo transfer in group 1, 6/9 (66.6% per transfer) resulted in sustained implantation/livebirth. In group 2, 1/2 (50% per transfer) resulted in sustained implantation/livebirth. In infertile men with NOA and a history of one failed mTESE, testicular PRP injection resulted in identification of sperm cells in 21.8% (12/55), and sustained implantation/livebirth rate of 10.9% (6/55). In men with NOA who failed 2 or more prior mTESE, PRP was less effective with identification of sperm cells in 8.3% (3/36), and sustained implantation/livebirth rate of 2.8% (1/36)." @default.
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• W3199393668 date "2021-09-01" @default.
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• W3199393668 title "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" @default.
• W3199393668 doi "https://doi.org/10.1016/j.fertnstert.2021.07.893" @default.
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