
Recurrent pregnancy loss and unexplained infertility are the current indications to test sperm DNA fragmentation, according to the European Association of Urology Guidelines on sexual and reproductive health. This study aims to identify a novel and better-performing model to diagnose primary infertile men presenting with altered sperm DNA fragmentation and to outline its predictive ability with respect to the current European Association of Urology Guidelines’ recommendations. As per this study, the application of the European Association of Urology sexual and reproductive health guidelines does not ensure proper identification of primary infertile men with pathological sperm DNA fragmentation. Therefore, this study proposes a novel and better-performing predictive model to identify infertile men with altered sperm DNA fragmentation at first clinical assessment. As altered sperm DNA fragmentation has been widely linked with the inability to conceive, second‐level test could be further implemented over the diagnostic workup of a broader subset of patients presenting for male factor infertility.
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