en تأثیر تزریق داخل بیضه‌ای پلاسمای غنی از پلاکت اتولوگ بر قطعه قطعه شدن DNA اسپرم در مردان مبتلا به الیگوآستنوتراتوزواسپرمی: یک کارآزمایی تصادفی کنترل‌شده Fertility & Infertility Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">الیگوآستنوتراتوزواسپرمیا (</span></span><span dir="LTR" style="font-size:10.0pt">OAT</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) یکی از شایع‌ترین علل چندعاملی ناباروری در مردان است. پلاسمای غنی از پلاکت (</span></span><span dir="LTR" style="font-size:10.0pt">PRP</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">)، یک محصول بیولوژیکی، به عنوان درمان ترمیمی امیدوارکننده در حوزه‌های مختلف پزشکی از جمله سلامت باروری ظهور کرده است. بنابراین، ما تأثیر تجویز </span></span><span dir="LTR" style="font-size:10.0pt">PRP</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> بر قطعه &shy;قطعه&shy; شدن </span></span><span dir="LTR" style="font-size:10.0pt">DNA</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> اسپرم (</span></span><span dir="LTR" style="font-size:10.0pt">SDF</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) را در مردان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">OAT</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> مورد بررسی قرار دادیم.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">ارزیابی تأثیر تزریق داخل بیضه‌ای </span></span><span dir="LTR" style="font-size:10.0pt">PRP</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> بر شاخص قطعه &shy;قطعه &shy;شدن (</span></span><span dir="LTR" style="font-size:10.0pt">DFI</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) در مردان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">OAT</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> ایدیوپاتیک و سنجش پتانسیل آن به عنوان یک مداخله درمانی نوین برای بهبود یکپارچگی </span></span><span dir="LTR" style="font-size:10.0pt">DNA</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> اسپرم بود.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش &shy;ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این مطالعه کارآزمایی بالینی تصادفی شاهددار شامل ۱۶۰ مرد نابارور با تشخیص </span></span><span dir="LTR" style="font-size:10.0pt">OAT</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> و بدون بیماری‌های زمینه‌ای بود که از تیر ماه ۱۴۰۲ تا تیر ماه ۱۴۰۳ به مرکز ناباروری فاطمیه همدان، ایران مراجعه کرده بودند. شرکت‌کنندگان با استفاده از روش تصادفی‌سازی بلوکی به 2 گروه مداخله و کنترل تقسیم شدند. گروه مداخله، ۱ تا ۲ سی‌سی </span></span><span dir="LTR" style="font-size:10.0pt">PRP</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> در هر بیضه دریافت کرد. پارامترهای اسپرم و </span></span><span dir="LTR" style="font-size:10.0pt">DFI</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> اندازه‌گیری شدند؛ همچنین یک مطالعه هورمونی قبل و بعد از عمل انجام شد.</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج، تفاوت معنی‌داری را در تعداد اسپرم&nbsp;</span></span><span lang="FA" style="font-size:11.0pt"><span cambria="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">ها (030/۰ </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">)، حرکت پیشرونده (001/0 </span></span><span lang="FA" style="font-size:10.0pt">> </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) قطعه &shy;قطعه &shy;شدن (001/0 </span></span><span lang="FA" style="font-size:10.0pt">> </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">)</span></span><span dir="LTR" style="font-size:10.0pt">DNA</span> <span style="font-size:11.0pt"><span b="" mitra="" style="font-family:">&nbsp;مورفولوژی طبیعی (001/0 </span></span><span lang="FA" style="font-size:10.0pt">> </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) و همچنین سطح تستوسترون (001/0 </span></span><span lang="FA" style="font-size:10.0pt">> </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) بین گروه‌های کنترل و مداخله پس از تزریق </span></span><span dir="LTR" style="font-size:10.0pt">PRP</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> نشان داد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه&shy; گیری: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">به نظر می‌رسد تزریق </span></span><span dir="LTR" style="font-size:10.0pt">PRP</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> یک رویکرد درمانی ایمن، کم‌تهاجمی و بالقوه مؤثر در افزایش غلظت و تحرک اسپرم و کاهش قطعه &shy;قطعه &shy;شدن </span></span><span dir="LTR" style="font-size:10.0pt">DNA</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> اسپرم در مردان مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">OAT</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> باشد.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"></span></span></b></span></span></span></span></span></div> <div style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="line-height:normal"><b>Background: </b>Oligoasthenoteratozoospermia (OAT) is one of the most common multifactorial causes of male infertility. Platelet-rich plasma (PRP), a biological product, has emerged as a promising regenerative therapy in various fields of medicine, including reproductive health. Therefore, we investigated the effect of PRP administration on sperm DNA fragmentation in OAT men.</span><br> <span style="line-height:normal"><b>Objective:</b> The aim was to evaluate the effect of intratesticular injection of PRP on DNA fragmentation index (DFI) in men with idiopathic OAT and assess its potential as a novel therapeutic intervention to enhance sperm DNA integrity.</span><br> <span style="line-height:normal"><b>Materials and Methods:</b> This randomized controlled trial study involved 160 infertile men diagnosed with OAT without underlying diseases who were referred to the infertility center of Fatemieh Infertility Center, Hamadan, Iran, from July 2023 to July 2024. The participants were randomly assigned to intervention and control groups using a block randomization method. The intervention group received 1-2 cc of PRP in each testicle. Sperm parameters and DFI were measured; a hormonal study was also performed before and after the procedure. </span><br> <span style="line-height:normal"><b>Results: </b>The results revealed a significant difference in concentration (p = 0.030), progressive motility (p < 0.001), DNA fragmentation (p < 0.001), normal morphology (p < 0.001), and also testosterone levels (p < 0.001) between groups after PRP injection. </span><br> <span style="line-height:normal"><b>Conclusion: </b>PRP Injection into the testis appears to be a safe, minimally invasive, and potentially effective therapeutic approach in enhancing sperm quality and reducing DFI in men with OAT. </span></span></span></div> ناباروری مردان, الیگوآستنوتراتوزواسپرمی, پلاسمای غنی از پلاکت, قطعه قطعه شدن DNA اسپرم. Male infertility, Oligoasthenoteratozoospermia, Platelet-rich plasma, Sperm DNA fragmentation. 421 432 http://ijrm.ir/browse.php?a_code=A-10-2932-2&slc_lang=en&sid=1 Shamim Pilehvari sh.pilehvari@yahoo.com 0000-0002-2639-2941 No Fertility and Infertility Research Center, Avicenna Institute of Clinical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran. Marzieh Ghorbani rozhinaghorbani@yahoo.com 0000-0001-9562-9378 No Fertility and Infertility Research Center, Avicenna Institute of Clinical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran. Hooshang Babalhavaeji H. Babalhavaeji @umsha.ac.ir 0009-0002-8575-6511 No Fertility and Infertility Research Center, Avicenna Institute of Clinical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran. Elaheh Talebi-Ghane talebi_ghane@yahoo.com 0009-0003-2610-1419 No Modeling of Noncommunicable Diseases Research Center, Institute of Health Sciences and Technologies, Avicenna Health Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran. Faezeh Fazli f.fazly@umsha.ac.ir 0009-0007-1860-0513 Yes Fertility and Infertility Research Center, Avicenna Institute of Clinical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.