Objective: To evaluate the efficacy of platelet-rich plasma (PRP) incubation on embryo developmental outcomes in intracytoplasmic sperm injection (ICSI) cycles involving low-quality sperm. Methods: Sixty-six couples undergoing ICSI were enrolled in a prospective randomised study conducted at Halim Fertility Center, Indonesia between January and August 2023. Male with severe oligoasthenoteratozoospermia were randomised into two groups. Following density gradient centrifugation, samples in the PRP group were incubated with autologous PRP for one hour prior to ICSI, whereas the non-PRP group underwent standard processing without PRP exposure. Baseline characteristics and assisted reproductive technology outcomes between two groups were compared. The primary outcome was the blastocyst formation rate, while secondary outcomes included fertilisation rate, cleavage rate, and blastocyst quality. Results: A total of 66 couples were included, with 33 couples in each group. Participants’ demographics and semen parameters did not differ significantly between the two groups. The PRP group demonstrated a higher fertilisation rate than the non-PRP group (84.1% vs. 78.2%), but the difference was not statistically significant ( P =0.38). The PRP group showed significantly higher cleavage rates (98.9% vs. 95.0%; P =0.03) and blastocyst formation rates (56.7% vs. 46.6%; P =0.006) compared to the non-PRP group. Additionally, the PRP group exhibited a higher proportion of good-quality blastocysts (44.8% vs. 41.2%; P =0.01) and a lower proportion of poor-quality blastocysts (22.1% vs. 27.8%; P =0.03). Conclusions: PRP incubation prior to ICSI in severe oligoasthenoteratozoospermia cases improves cleavage rates, blastocyst formation, and embryo quality. PRP may be a promising adjunct to optimise ICSI outcomes in male factor infertility. Study registration: This study was registered at ClinicalTrials.gov with the registration number NCT07579858.
Halim et al. (Fri,) studied this question.