{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:05:58Z","timestamp":1791925558493,"version":"4.3.4"},"reference-count":48,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Male infertility contributes to nearly half of infertile couples, with asthenozoospermia and oligoasthenoteratozoospermia as predominant factors. Despite advancements in sperm processing techniques, the outcomes remain limited in severe cases, particularly concerning motility, mitochondrial function, and DNA integrity. Platelet-rich plasma (PRP), an autologous concentrate rich in platelets (&gt;1 \u00d7 106\/\u03bcL) and growth factors, has recently gained attention as an adjunctive therapy in andrology and assisted reproduction. This review systematically evaluated studies published between 2015 and 2025 investigating PRP use in sperm processing, including in vitro experiments, clinical trials, animal models, and mechanistic studies. PRP demonstrated concentration-dependent benefits, with 5% PRP yielding optimal improvements: motility increased by 15\u201330%, mitochondrial activity increased by up to 80% (p = 0.002), and oxidative stress was significantly reduced (p &lt; 0.001). PRP\u2019s effects on DNA integrity differ by application method: intratesticular administration improves spermatogenesis, producing sperm with reduced DNA fragmentation (~33% relative reduction after 3 months, p &lt; 0.001), while in vitro supplementation provides limited protection against processing-induced damage. Mechanisms involve antioxidant action, mitochondrial protection via AMP-activated protein kinaseNuclear Factor kappa-light-chain-enhancer of activated B cells (AMPK\/NF-\u03baB) modulation, membrane stabilization, and the selective preservation of higher-quality spermatozoa. PRP shows consistent biological efficacy and safety but lacks methodological standardization. Fewer than 20% of studies report platelet concentrations, limiting reproducibility. Standardized protocols distinguishing leukocyte-poor from leukocyte-rich preparations and randomized trials focusing on live birth rates are recommended. This review proposes an eight-point characterization checklist for future research.<\/jats:p>","DOI":"10.3390\/ijms27052177","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T09:31:32Z","timestamp":1772098292000},"page":"2177","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Platelet-Rich Plasma in Sperm Processing for Assisted Reproductive Technology: Molecular Mechanisms, Clinical Applications, and Future Directions"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8413-6084","authenticated-orcid":false,"given":"Du\u0161ica","family":"Petrovi\u0107","sequence":"first","affiliation":[{"name":"Pronatal Hospital, Dunavska 2, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marija","family":"Dini\u0107","sequence":"additional","affiliation":[{"name":"Department of Transfusiology, University Clinical Center of Serbia, Vi\u0161egradska 26, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dajana","family":"\u0160vraka","sequence":"additional","affiliation":[{"name":"Teofanovi\u0107 Hospital, Kralja Bodina 6, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veljko","family":"Pantovi\u0107","sequence":"additional","affiliation":[{"name":"Nacionalni Centar za Infertilitet I Endokrinologiju Pola, Klinika za Endokrinologiju, Dijabetes I Bolesti Metabolizma, Univerzitetski Klini\u010dki Centar Srbije, Doktora Suboti\u0107a 13, 11000 Beograd, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilija Petanovska","family":"Kostova","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, University Goce Delcev Stip, 2000 \u0160tip, North Macedonia"},{"name":"IVF Centar ReMedika Skopje, 1000 Skopje, North Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goran","family":"Malenkovi\u0107","sequence":"additional","affiliation":[{"name":"Medicinski Fakultet, Univerzitet u Novom Sadu, Hajduk Veljkova 3, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandar","family":"Ljubi\u0107","sequence":"additional","affiliation":[{"name":"Teofanovi\u0107 Hospital, Kralja Bodina 6, 11000 Belgrade, Serbia"},{"name":"International Academy of Sciences and Arts of Bosnia and Herzegovina, Paromlinska 53, 71000 Sarajevo, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s12958-015-0032-1","article-title":"A unique view on male infertility around the globe","volume":"13","author":"Agarwal","year":"2015","journal-title":"Reprod. 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