Evaluation of the Effect of Platelet-Rich Fibrin (PRF) Protocol and Laser Acupuncture in the Treatment of Infertile Men with Non-Obstructive Azoospermia: A Randomized Clinical Trial.

Introduction: Non-obstructive azoospermia (NOA) is a challenging male infertility disorder with limited treatment options. This study investigated the efficacy of novel reconstructive approaches, specifically platelet-rich fibrin (PRF), with and without laser needling, in improving testicular function and sperm retrieval in patients with NOA. Methods: In a randomized clinical trial, 40 men with NOA were divided into two groups: PRF + laser and PRF alone. Semen parameters (volume, concentration, motility, morphology, DNA fragmentation), hormone levels (FSH, LH, testosterone), and testicular volume were assessed at baseline, immediately post-intervention, and at one and three months. Results: Sperm concentration, motility, morphology, and DNA fragmentation rates showed no significant intergroup differences. While semen volume increased within groups post-intervention (P=0.039), this change was not significant between groups (P>0.05). No serious complications were reported. Conclusion: In summary, this study found that PRF injection, with or without laser-acupuncture, did not significantly improve sperm parameters in NOA patients in the short term. Further research with larger cohorts, extended follow-up, and precise patient selection is needed.