Intratesticular platelet-rich plasma (PRP) application to improve testicular development, hemodynamic and testosterone in male lambs

Öz

The purpose of this study was to evaluate the effect of periodic intratesticular PRP administration on testicular development in male lambs by examining the changes in testosterone levels, testicular morphometry, and supratesticular artery hemodynamic. The control group lambs (n=16) received an intratesticular injection of saline solution, while the experimental group lambs (n=16) were administered autologous PRP. Injections were administered monthly for a period of 10 months. Following the initial PRP injection in June, testosterone levels, testicular morphometric measurements, and spermatic cord Doppler ultrasonography measurements were assessed on a monthly basis for a period of 10 months (July to April). Platelet counts in whole blood and PRP, and growth factor levels in PRP were also analysed. Testicular blood flow in October, scrotal thickness in December, and testicular length in April were significantly higher in the PRP group compared to the control group (p<0.05). Furthermore, the resistance index value among Doppler ultrasonography parameters was observed to be lower in the PRP group compared to the control group (p<0.05). Significant inter-month differences were observed in platelet counts in whole blood (p<0.001) and PRP (p<0.001), as well as in FGF1 levels in PRP (p<0.05). It is hypothesized that the administration of PRP to lambs at an early age may exert a slight beneficial influence on testicular development, attributable to the presence of certain growth factors within the PRP.

Anahtar Kelimeler

• Lamb
• Platelet-rich plasma
• Testosterone
• Testicular size
• Testicular hemodynamic

Destekleyen Kurum

This work was supported by the Scientific and Technological Research Council of Türkiye (TÜBİTAK) (Grant No: 120O558).

Proje Numarası

120O558

Etik Beyan

The approval for the study was taken from Fırat University Animal Experiments Local Ethics Committee (Protocol No: 2020/05).

Teşekkür

This study is part of Aslıhan ÇAKIR CİHANGİROĞLU’s PhD thesis.

Erkek kuzularda testiküler gelişimi, hemodinamiği ve testosteron düzeyini iyileştirmek amacıyla intratestiküler trombositten zengin plazma (PRP) uygulaması

Öz

Bu çalışmanın amacı, erkek kuzularda periyodik intratestiküler PRP uygulamasının testiküler gelişim üzerine etkisini; testosteron düzeyleri, testiküler morfometri ve supratestiküler arter hemodinamiğindeki değişiklikleri inceleyerek değerlendirmektir. Kontrol grubundaki kuzulara (n=16) intratestiküler serum fizyolojik enjeksiyonu uygulanırken, deney grubundaki kuzulara (n=16) otolog PRP uygulanmıştır. Enjeksiyonlar 10 ay boyunca aylık olarak gerçekleştirilmiştir. Haziran ayında yapılan ilk PRP uygulamasını takiben, testosteron düzeyleri, testiküler morfometrik ölçümler ve spermatik kordon Doppler ultrasonografi ölçümleri 10 ay süreyle (Temmuz–Nisan) aylık olarak değerlendirilmiştir. Ayrıca tam kanda ve PRP’de trombosit sayıları ile PRP’deki büyüme faktörü düzeyleri analiz edilmiştir. PRP grubunda, Ekim ayında testiküler kan akımı, Aralık ayında skrotal kalınlık ve Nisan ayında testiküler uzunluk kontrol grubuna kıyasla anlamlı derecede daha yüksek bulunmuştur (p<0,05). Ayrıca Doppler ultrasonografi parametrelerinden direnç indeksi değerinin PRP grubunda kontrol grubuna göre daha düşük olduğu belirlenmiştir (p<0,05). Tam kandaki trombosit sayılarında (p<0,001), PRP’deki trombosit sayılarında (p<0,001) ve PRP’deki FGF1 düzeylerinde (p<0,05) aylar arasında anlamlı farklılıklar gözlenmiştir. Erken yaşta kuzulara PRP uygulanmasının, PRP içeriğinde bulunan bazı büyüme faktörlerine bağlı olarak testiküler gelişim üzerinde hafif düzeyde olumlu bir etki gösterebileceği düşünülmektedir.

Anahtar Kelimeler

• Kuzu
• Platelet-rich plasma
• Testosteron
• Testis büyüklüğü
• Testiküler hemodinami

Destekleyen Kurum

Bu çalışma, Türkiye Bilim ve Teknolojik Araştırma Konseyi ( TÜBİTAK ) tarafından desteklenmiştir (Proje No: 120O558 ).

Proje Numarası

120O558

Etik Beyan

Çalışma için Fırat Üniversitesi Hayvan Deneyleri Yerel Etik Kurulu'ndan onay alınmıştır (Protokol No: 2020/05).

Teşekkür

Bu çalışma, Aslıhan ÇAKIR CİHANGİROĞLU'nun doktora tezinin bir parçasıdır.

Kaynakça

1. Abdulla, A. K., Id, T. R., & AlDelemi, D. H. J. (2022). Testicular injection of autologous platelet-rich plasma (PRP) to enhance the sperm parameters in rabbit. European Journal of Medical Research, 7, 171–179.
2. Aksoy, M., Ataman, M. B., Karaca, F., & Kaya, A. (1994). Interrelationships between morphometric measurements of testes and sperm quality in Merino rams (in Turkish). Veteriner Bilimleri Dergisi, 10, 127–129. Alves, R., & Grimalt, R. (2018). A review of platelet-rich plasma: History, biology, mechanism of action, and classification. Skin Appendage Disorders, 4, 18–24. https://doi.org/10.1159/000477353
3. Angelou, V., Psalla, D., Dovas, C. I., Kazakos, G. M., et al. (2022). Locally injected autologous platelet-rich plasma improves cutaneous wound healing in cats. Animals, 12, 1993. https://doi.org/10.3390/ani12151993
4. Anitua, E., Muruzabal, F., de la Fuente, M., Merayo, J., et al. (2016). Plasma rich in growth factors for the treatment of ocular surface diseases. Current Eye Research, 41, 875–882. https://doi.org/10.3109/02713683.2015.1104362
5. Basciani, S., Mariani, S., Spera, G., & Gnessi, L. (2010). Role of platelet-derived growth factors in the testis. Endocrine Reviews, 31, 916–939. https://doi.org/10.1210/er.2010-0004
6. Basran, S. S., Negri, F., Langroudi, A. P., Sellke, N., Stinson, J., Ha, A., et al. (2026). The effect of intratesticular platelet-rich plasma injection on sperm retrieval rates in non-obstructive azoospermia males after failed testicular sperm extraction: An inception cohort. The World Journal of Men's Health, 44. https://doi.org/10.5534/wjmh.250281
7. Bearden, H. J., Fuquay, J. W., & Willard, S. T. (2003). Applied animal reproduction. Pearson Prentice Hall. Bergh, A., & Damber, J. E. (1993). Vascular controls in testicular physiology. In David de Kretser (Ed.), Molecular biology of the male reproductive system (1st ed., pp. 439–468). Academic Press. https://doi.org/10.1016/B978-0-08-091764-1.50017-9
8. Biagiotti, G., Cavallini, G., Modenini, F., Vitali, G., et al. (2002). Spermatogenesis and spectral echo-colour Doppler traces from the main testicular artery. BJU International, 90, 903–908. https://doi.org/10.1046/j.1464-410X.2002.03033.x

9. Bir, S. C., Esaki, J., Marui, A., Yamahara, K., et al. (2009). Angiogenic properties of sustained release platelet-rich plasma: Characterization in vitro and in the ischemic hind limb of the mouse. Journal of Vascular Surgery, 50, 870–879. https://doi.org/10.1016/j.jvs.2009.06.016
10. Boote, E. J. (2003). AAPM/RSNA physics tutorial for residents: Topics in US: Doppler US techniques: Concepts of blood flow detection and flow dynamics. Radiographics, 23, 1315–1327. https://doi.org/10.1148/rg.235035080
11. Camargo, P. M., Lekovic, V., Weinlaender, M., Vasilic, N., et al. (2002). Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans. Journal of Periodontal Research, 37, 300–306. https://doi.org/10.1034/j.1600-0765.2002.01001.x
12. Camela, E. S., Nociti, R. P., Santos, V. J., Macente, B. I., et al. (2019). Changes in testicular size, echotexture, and arterial blood flow associated with the attainment of puberty in Dorper rams raised in a subtropical climate. Reproduction in Domestic Animals, 54, 131–137. https://doi.org/10.1111/rda.13213
13. Cameli, N., Mariano, M., Cordone, I., Abril, E., et al. (2017). Autologous pure platelet-rich plasma dermal injections for facial skin rejuvenation. Dermatologic Surgery, 43, 826–835. https://doi.org/10.1097/DSS.0000000000001083
14. Chemineau, P., Bodin, L., Migaud, M., Thiéry, J. C., et al. (2010). Neuroendocrine and genetic control of seasonal reproduction in sheep and goats. Reproduction in Domestic Animals, 45, 42–49. https://doi.org/10.1111/j.1439-0531.2010.01661.x
15. Cornell University College of Veterinary Medicine. (2024). Hemostasis, platelet number, critical values. https://eclinpath.com/hemostasis/tests/platelet-number
16. Damber, J. E., Bergh, A., & Daehlin, L. (1985). Testicular blood flow, vascular permeability, and testosterone production after hCG stimulation in cryptorchid rats. Endocrinology, 117, 1906–1913. https://doi.org/10.1210/endo-117-5-1906
17. de Obarrio, J. J., Araúz-Dutari, J. I., Chamberlain, T. M., & Croston, A. (2000). The use of autologous growth factors in periodontal surgical therapy: Platelet gel biotechnology—Case reports. International Journal of Periodontics & Restorative Dentistry, 20, 486–497.
18. Dehghani, F., Sotoude, N., Bordbar, H., Panjeshahin, M. R., et al. (2019). The use of platelet-rich plasma (PRP) to improve structural impairment of rat testis induced by busulfan. Platelets, 30, 513–520. https://doi.org/10.1080/09537104.2018.1478400
19. Dhananjaya, S., Pawan, A., Sharad, J., & Reena, K. (2018). Autologous platelet-rich plasma for treatment of ischemic ulcers in Buerger's disease: A pilot study with short-term results. Indian Journal of Vascular and Endovascular Surgery, 5, 14–20. https://doi.org/10.4103/ijves.ijves_47_17
20. Dhurat, R., & Sukesh, M. (2014). Principles and methods of preparation of platelet-rich plasma: A review. Journal of Cutaneous and Aesthetic Surgery, 7, 189–197. https://doi.org/10.4103/0974-2077.150734
21. Donnelly, C., Minty, I., Dsouza, A., Wong, Y. Y., et al. (2024). The role of platelet-rich plasma in androgenetic alopecia: A systematic review. Journal of Cosmetic Dermatology, 23, 1551–1559. https://doi.org/10.1111/jocd.16185
22. Elmaz, Ö., Cirit, Ü., & Demir, H. (2007). Relationship of testicular development with age, body weight, semen characteristics and testosterone in Kivircik ram lambs. South African Journal of Animal Science, 37, 269–274. https://doi.org/10.4314/sajas.v37i4.4100
23. Epifanova, M. V., Gvasalia, B. R., Durashov, M. A., & Artemenko, S. A. (2020). Platelet-rich plasma therapy for male sexual dysfunction. Sexual Medicine Reviews, 8, 106–113. https://doi.org/10.1016/j.sxmr.2019.02.002
24. Fernandez-Abella, D., Becu-Villalobos, D., Lacau-Mengido, I. M., Villegas, N., et al. (1999). Sperm production and hormonal profiles in Merino and Corriedale rams. Reproduction Nutrition Development, 39, 617–624. https://doi.org/10.1051/rnd:19990508
25. Foster, T. E., Puskas, B. L., Mandelbaum, B. R., Gerhardt, M. B., et al. (2009). Platelet-rich plasma: From basic science to clinical applications. American Journal of Sports Medicine, 37, 2259–2272. https://doi.org/10.1177/0363546509349921
26. Fujii, N., Uta, S., Kobayashi, M., Sato, T., Okita, N., & Higami, Y. (2019). Impact of aging and caloric restriction on fibroblast growth factor 21 signaling in rat white adipose tissue. Experimental Gerontology, 118, 55–64. https://doi.org/10.1016/j.exger.2019.01.001
27. Gromoll, J., Eiholzer, U., Nieschlag, E., & Simoni, M. (2000). Male hypogonadism caused by LH receptor deletion. Journal of Clinical Endocrinology & Metabolism, 85, 2281–2286. https://doi.org/10.1210/jcem.85.6.6636
28. Gündoğan, M., Uçar, M., Tekerli, M., & Yeni, D. (2003). Possible association between age and reproductive parameters in Akkaraman rams during breeding season (in Turkish). Hayvansal Araştırma Dergisi, 13, 13–18.
29. Habibu, B., Abdullahi, A., Yaqub, L. S., Makun, H. J., et al. (2017). Variations in platelet count and total protein in relation to differences in sex, age, breed and reproductive status of goats during the cold-dry season (Harmattan). Journal of Dairy, Veterinary & Animal Research, 5, 89–94. https://doi.org/10.15406/jdvar.2017.05.00141
30. Haidar, Z. S. (2024). Platelet-rich plasma therapy in the management of male infertility. Biofunctional Materials, 2, 0006. https://doi.org/10.55092/bm20240006
31. Hauschild, G., Geburek, F., Gosheger, G., Eveslage, M., et al. (2016). Storage stability of platelet-rich plasma in horses. BMC Veterinary Research, 13, 7. https://doi.org/10.1186/s12917-016-0920-4,
32. Hedia, M., & El-Belely, M. (2021). Testicular morphometric and echotextural parameters in Ossimi rams. Large Animal Review, 27, 77–82.
33. Hedia, M. G., El-Belely, M. S., Ismail, S. T., & El-Maaty, A. M. A. (2019). Monthly changes in testicular blood flow in rams. Theriogenology, 123, 68–73. https://doi.org/10.1016/j.theriogenology.2018.09.032
34. Herrera-Alarcón, J., Villagómez-Amezcua, E., González-Padilla, E., & Jiménez-Severiano, H. (2007). Postnatal testicular development in Blackbelly sheep. Theriogenology, 68, 582–591. https://doi.org/10.1016/j.theriogenology.2007.01.020
35. Ho, C. H., & Chan, I. H. (1995). The influence of time of storage, temperature of storage, platelet number in platelet-rich plasma, packed cell, mean platelet volume, hemoglobin concentration, age, and sex on platelet aggregation test. Annals of Hematology, 71, 129–133. https://doi.org/10.1007/BF01702648
36. Hwang, G. S., Wang, S. W., Tseng, W. M., Yu, C. H., & Wang, P. S. (2007). Effect of hypoxia on VEGF and testosterone release. American Journal of Physiology-Endocrinology and Metabolism, 292, E1763–E1769. https://doi.org/10.1152/ajpendo.00611.2006
37. Jin, Y. M., Zhang, X. Q., Badgery, W. B., Li, P., et al. (2019). Effects of winter and spring housing on growth performance and blood metabolites of Pengbo semi-wool sheep in Tibet. Asian-Australasian Journal of Animal Sciences, 32, 1630–1639. https://doi.org/10.5713/ajas.18.0966
38. Kafi, M., Safdarian, M., & Hashemi, M. (2004). Seasonal variation in semen characteristics of rams. Small Ruminant Research, 53, 133–139. https://doi.org/10.1016/j.smallrumres.2003.07.007
39. Karadağ Sarı, Ç. (2022). Factors affecting platelet count in platelet-rich plasma. Journal of Dokuz Eylul University Medical Faculty, 36, 159–166. https://doi.org/10.18614/deutip.1174537
40. Kaya, C., Esin, B., & Esin, Ç. (2025). Evaluation of testicular arterial Doppler ultrasonography and spermatological parameters in Pomeranian dogs with alopecia X. Kocatepe Veterinary Journal, 18(1), 25–32. https://dergipark.org.tr/en/pub/kvj/article/1577469
41. Khalifa, E. I., Ahmed, M. E., Hafez, Y. H., El-Zolaky, O. A., et al. (2013). Age at puberty and fertility of Rahmani sheep fed on biological inoculated corn silage. Annals of Agricultural Sciences, 58, 163–172. https://doi.org/10.1016/j.aoas.2013.07.003
42. Koyuncu, M., Uzun, Ş. K., Öziş, S., & Duru, S. (2005). Development of testicular dimensions and size, and their relationship to age and body weight in growing Kivircik (Western Thrace) ram lambs. Czech Journal of Animal Science, 50, 243–248. https://doi.org/10.17221/4164-CJAS
43. Kutluhan, M. A., Özsoy, E., Şahin, A., et al. (2021). Effects of platelet-rich plasma on spermatogenesis. Andrology, 9, 407–413. https://doi.org/10.1111/andr.12895
44. Le, A. D., Enweze, L., DeBaun, M. R., & Dragoo, J. L. (2018). Current clinical recommendations for use of platelet-rich plasma. Current Reviews in Musculoskeletal Medicine, 11, 624–634. https://doi.org/10.1007/s12178-018-9527-7
45. Maksimovic, N., Hristov, S., Stankovic, B., Petrovic, C., et al. (2016). Investigation of serum testosterone level, scrotal circumference, body mass, semen characteristics, and their correlations in developing MIS lambs. Turkish Journal of Veterinary and Animal Sciences, 40, 53–59. https://doi.org/10.3906/vet-1505-61
46. Mariano, R., Messora, M., de Morais, A., Nagata, M., et al. (2010). Bone healing in critical-size defects treated with platelet-rich plasma: A histologic and histometric study in the calvaria of diabetic rat. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 109, 72–78. https://doi.org/10.1016/j.tripleo.2009.08.003
47. Martin-Sole, O., Rodo, J., Garcia-Aparicio, L., Blanch, J., et al. (2016). Effects of platelet-rich plasma on renal ischemia-reperfusion. PLoS ONE, 11, e0160703. https://doi.org/10.1371/journal.pone.0160703
48. Masterson, T. A., Molina, M., Ledesma, B., Zucker, I., et al. (2023). Platelet-rich plasma for the treatment of erectile dysfunction: A prospective, randomized, double-blind, placebo-controlled clinical trial. Journal of Urology, 210, 154–161. https://doi.org/10.1097/JU.0000000000003481
49. Matz, E. L., Pearlman, A. M., & Terlecki, R. P. (2018). Safety and feasibility of platelet rich fibrin matrix injections for treatment of common urologic conditions. Investigative and Clinical Urology, 59, 61–65. https://doi.org/10.4111/icu.2018.59.1.61
50. Mishra, A., Woodall, J., Jr., & Vieira, A. (2009). Treatment of tendon and muscle using platelet-rich plasma. Clinical Sports Medicine, 28, 113–125. https://doi.org/10.1016/j.csm.2008.08.007
51. Morad, A., Elgendy, H., & Assar, T. (2021). Autologous platelet-rich plasma to prevent a thin endometrium in patients undergoing clomiphene citrate therapy: A pilot prospective self-controlled trial. Evidence Based Women’s Health Journal, 11, 10–16. https://doi.org/10.21608/EBWHJ.2020.45846.1114
52. Mohamed, A., Fathi, M., Shamaa, A. A., & El Shahat, K. H. (2025). Impact of autologous platelet-rich plasma used for treatment of oligozoospermia in dogs on the quality of semen and testicular blood flow. Veterinary Research Communications, 49(3), 182. https://doi.org/10.1007/s11259-025-10734-8
53. Nazari-Zenouz, F., Moghaddam, G. H., Hamidian, G., Ashrafi, J., et al. (2016). Postnatal testicular development and testosterone changes in Ghezel ram lambs. Small Ruminant Research, 141, 70–76. https://doi.org/10.1016/j.smallrumres.2016.07.001
54. Oatley, J. M., de Avila, D. M., Reeves, J. J., & McLean, D. J. (2004). Spermatogenesis and germ cell transgene expression in xenografted bovine testicular tissue. Biology of Reproduction, 71, 494–501. https://doi.org/10.1095/biolreprod.104.027953
55. Ohyama, K., Ohta, M., Nakagomi, Y., Yamori, T., et al. (1995). Effects of growth hormone and insulin-like growth factor I on testosterone secretion in premature male rats. Endocrine Journal, 42, 817–820. https://doi.org/10.1507/endocrj.42.817
56. Patel, A. N., Selzman, C. H., Kumpati, G. S., McKellar, S. H., et al. (2016). Evaluation of autologous platelet-rich plasma for cardiac surgery: Outcome analysis of 2000 patients. Journal of Cardiothoracic Surgery, 11, 62. https://doi.org/10.1186/s13019-016-0452-9
57. Pavlovic, V., Ciric, M., Jovanovic, V., & Stojanovic, P. (2016). Platelet rich plasma: A short overview of certain bioactive components. Open Medicine, 11, 242–247. https://doi.org/10.1515/med-2016-0048
58. Pinggera, G. M., Mitterberger, M., Bartsch, G., Strasser, H., Gradl, J., Aigner, F., & Frauscher, F. (2008). Assessment of the intratesticular resistive index by colour Doppler ultrasonography measurements as a predictor of spermatogenesis. BJU International, 101(6), 722–726. https://doi.org/10.1111/j.1464-410X.2007.07343.x
59. Pozor, M. A. (2007). Evaluation of testicular vasculature in stallions. Clinical Techniques in Equine Practice, 6, 271–277. https://doi.org/10.1053/j.ctep.2007.09.007
60. Pozor, M. A., & McDonnell, S. M. (2004). Color Doppler ultrasound evaluation of testicular blood flow in stallions. Theriogenology, 61, 799–810. https://doi.org/10.1016/S0093-691X(03)00227-9
61. Preston, B. T., Stevenson, I. R., Lincoln, G. A., Monfort, S. L., et al. (2012). Testes size and testosterone production. Journal of Animal Ecology, 81, 296–305. https://doi.org/10.1111/j.1365-2656.2011.01907.x
62. Ribeiro, D. L. S., Santos, L. S., França, I. G., et al. (2020). The use of Doppler ultrasound as a potential fertility predictor in male goats. Turkish Journal of Veterinary and Animal Sciences, 44, 1115–1124. https://doi.org/10.3906/vet-2003-135
63. Risbridger, G. P. (1993). Effects of platelet-derived growth factor on Leydig cells. Molecular and Cellular Endocrinology, 97, 125–128. https://doi.org/10.1016/0303-7207(93)90218-9
64. Rizal, D. M., Hermilasari, R. D., & Wirohadidjojo, Y. W. (2020). Effect of platelet-rich plasma (PRP) on testicular damage in streptozotocin-induced diabetic rats. Bali Medical Journal, 9, 351–355. https://doi.org/10.15562/bmj.v9i1.1718
65. Romashchenko, O., Grygorenko, V., Biloholovska, V., Babych, O., et al. (2022). Use of platelet-rich plasma for the treatment of dyspareunia in postmenopausal women. Journal of Sexual Medicine, 19(Suppl.), S34. https://doi.org/10.1016/j.jsxm.2022.08.114
66. Ruiz-Muñoz, M., Martinez-Barrios, F., Fernandez-Torres, R., Lopezosa-Reca, E., et al. (2024). Autologous platelet-rich plasma (APRP) in diabetes foot disease: A meta-analysis. Journal of Diabetes and Its Complications, 38, 108690. https://doi.org/10.1016/j.jdiacomp.2024.108690
67. Saeed, F. F., & Zaid, N. W. (2019). Serum and testicular testosterone levels of ram lamb during puberty. Advances in Animal and Veterinary Sciences, 7, 92–95. https://doi.org/10.17582/journal.aavs/2019/7.2.92.95
68. Samir, H., Nyametease, P., Nagaoka, K., & Watanabe, G. (2018). Effect of seasonality on testicular blood flow as determined by color Doppler ultrasonography and hormonal profiles in Shiba goats. Animal Reproduction Science, 197, 185–192. https://doi.org/10.1016/j.anireprosci.2018.08.027
69. Samir, H., Radwan, F., & Watanabe, G. (2021). Advances in applications of color Doppler ultrasonography in the andrological assessment of domestic animals: A review. Theriogenology, 161, 252–261. https://doi.org/10.1016/j.theriogenology.2020.12.002
70. Sánchez-González, D. J., Méndez-Bolaina, E., & Trejo-Bahena, N. I. (2012). Platelet-rich plasma peptides: Key for regeneration. International Journal of Peptides, 2012, 532519. https://doi.org/10.1155/2012/532519
71. Sekerci, C. A., Tanidir, Y., Sener, T. E., Sener, G., et al. (2017). Effects of platelet-rich plasma against experimental ischemia/reperfusion injury in rat testis. Journal of Pediatric Urology, 13, 317.e1–317.e9. https://doi.org/10.1016/j.jpurol.2016.12.016
72. Somova, O., Ivanova, H., Sotnyk, N., Kovalenko, K., et al. (2021). The effectiveness of the platelet-rich plasma treatment of men with severe oligoasthenoteratozoospermia. Human Reproduction, 36(Suppl. 1), deab127.041. https://doi.org/10.1093/humrep/deab127.041
73. Sordoillet, C., Savona, C., Chauvin, M. A., De Peretti, E., et al. (1992). Basic fibroblast growth factor enhances testosterone secretion in cultured porcine Leydig cells: Site(s) of action. Molecular and Cellular Endocrinology, 89, 163–171. https://doi.org/10.1016/0303-7207(92)90222-R
74. Taschieri, S., Lolato, A., Ofer, M., Testori, T., et al. (2017). Immediate post-extraction implants with or without pure platelet-rich plasma: A 5-year follow-up study. Oral and Maxillofacial Surgery, 21, 147–157. https://doi.org/10.1007/s10006-017-0609-2
75. Teymur, H., Tiftikcioglu, Y. O., Cavusoglu, T., Tiftikcioglu, B. I., et al. (2017). Effect of platelet-rich plasma on reconstruction with nerve autografts. Kaohsiung Journal of Medical Sciences, 33, 69–77. https://doi.org/10.1016/j.kjms.2016.11.005
76. Türk, G., Sönmez, M., & Şimşek, Ü. G. (2005). Comparison of some reproductive features of pure hair goat bucks and Saanen × hair goat (F1) crossbreed bucks. Fırat Üniversitesi Sağlık Bilimleri Dergisi, 19, 87–92 . Vali, S., Saso, S., Bracewell-Milnes, T., Nicopoullos, J., et al. (2023). The clinical application of platelet-rich plasma in the female reproductive system: A narrative review. Life, 13, 2348. https://doi.org/10.3390/life13122348
77. Velasco, A., & Ruiz, S. (2020). New approaches to assess fertility in domestic animals: Relationship between arterial blood flow to the testicles and seminal quality. Animals, 11, 12. https://doi.org/10.3390/ani11010012
78. Venianaki, A. P., Barbagianni, M. S., Fthenakis, G. C., Galatos, A. D., et al. (2023). Doppler examination of the testicular artery of Beagle-breed dogs from birth to puberty. Tomography, 9, 1408–1422. https://doi.org/10.3390/tomography9040112
79. Yılmaz, B., & Kesikburun, S. (2013). Platelet-rich plasma applications. Turkish Journal of Physical Medicine and Rehabilitation, 59, 338–344. https://doi.org/10.4274/tftr.78700
80. Zelli, R., Troisi, A., Ngonput, A. E., Cardinali, L., et al. (2013). Doppler evaluation of testicular artery blood flow in dogs. Research in Veterinary Science, 95, 632–637. https://doi.org/10.1016/j.rvsc.2013.04.023