{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T23:29:57Z","timestamp":1784330997621,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T00:00:00Z","timestamp":1718928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the distribution of sperm DNA fragmentation (SDF) values and their association with clinical and seminal parameters in idiopathic infertile men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Patients, Measurements<\/jats:title><jats:p>Data from 3224 primary infertile men (belonging to couples having failed to conceive a pregnancy within 12 months) who underwent a thorough diagnostic work\u2010up were analysed. A SDF value\u2009\u2265\u200930% (according to Sperm Chromatin Structure Assay) was considered pathologic. We excluded: (1) men with genetic abnormalities; (2) men with history of cryptorchidism; (3) men with biochemical hypogonadism; (4) men with clinical varicocele; and (5) men with other possible known aetiological factors. Descriptive statistics and logistic regression analyses were used to describe the whole cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of all, 792 (23%) men with at least one abnormal WHO semen parameter but without any identified aetiologic factor for infertility, were considered as idiopathic infertile men. Of 792, 418 (52.7%) men had SDF\u00a0\u226530%. Men with pathologic SDF were older (<jats:italic>p<\/jats:italic>\u2009=\u2009.02), had higher Follicle\u2010stimulating hormone\u00a0(FSH) (<jats:italic>p<\/jats:italic>\u2009=\u2009.04) but lower total testosterone (<jats:italic>p<\/jats:italic>\u2009=\u2009.03) values than those with SDF\u00a0&lt;30%. The homoeostatic model assessment index for insulin resistance (HOMA\u2010IR) was higher in men with SDF\u00a0\u226530% (<jats:italic>p<\/jats:italic>\u2009=\u2009.01). Idiopathic infertile men with SDF\u00a0\u226530% presented with lower sperm concentration (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and lower progressive sperm motility (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) than those with SDF\u2009&lt;\u200930%. Logistic regression analysis revealed that older age (OR: 1.1, <jats:italic>p<\/jats:italic>\u2009=\u2009.02) and higher HOMA\u2010IR score (OR: 1.8, <jats:italic>p<\/jats:italic>\u2009=\u2009.03) were associated with SDF\u2009\u2265\u200930%, after accounting for FSH and sperm concentration values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Approximately half of infertile men categorized as idiopathic had pathologic SDF values. Idiopathic infertile men with pathologic SDF showed worse clinical, hormonal\u00a0and semen parameters than those with normal SDF values. These results suggest that including SDF testing could be clinically relevant over the real\u2010life management work\u2010up of infertile men.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.15093","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T19:38:49Z","timestamp":1718998729000},"page":"153-161","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["One out of two idiopathic infertile men has pathologic sperm DNA fragmentation values: Potential implications for clinical practice"],"prefix":"10.1111","volume":"101","author":[{"given":"Luca","family":"Boeri","sequence":"first","affiliation":[{"name":"Department of Urology Fondazione IRCCS Ca' Granda\u2013Ospedale Maggiore Policlinico Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Pozzi","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, URI, IRCCS Ospedale San Raffaele Milan Italy"},{"name":"University Vita\u2010Salute San Raffaele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Belladelli","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, URI, IRCCS Ospedale San Raffaele Milan Italy"},{"name":"University Vita\u2010Salute San Raffaele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9603-1589","authenticated-orcid":false,"given":"Christian","family":"Corsini","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, URI, IRCCS Ospedale San Raffaele Milan Italy"},{"name":"University Vita\u2010Salute San Raffaele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Cilio","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, URI, IRCCS Ospedale San Raffaele Milan Italy"},{"name":"Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit University of Naples \u2018Federico II\u2019 Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Bertini","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, URI, IRCCS Ospedale San Raffaele Milan Italy"},{"name":"University Vita\u2010Salute San Raffaele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Lanzaro","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, URI, IRCCS Ospedale San Raffaele Milan Italy"},{"name":"University Vita\u2010Salute San Raffaele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Candela","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, URI, IRCCS Ospedale San Raffaele Milan Italy"},{"name":"University Vita\u2010Salute San Raffaele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Raffo","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, URI, IRCCS Ospedale San Raffaele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Negri","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, URI, IRCCS Ospedale San Raffaele Milan Italy"},{"name":"University Vita\u2010Salute San Raffaele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovica","family":"Cella","sequence":"additional","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology, URI, IRCCS Ospedale San Raffaele Milan Italy"},{"name":"University Vita\u2010Salute San Raffaele Milan 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