Infertility, recurrent pregnancy loss and sperm DNA fragmentation, have we found the missing link?

Infertility, defined as the inability to achieve pregnancy after 12 months of unprotected intercourse (1), affects approximately 15% of the couples at reproductive age (2,3). Globally, infertility rates are increasing (4) and as a consequence the use of fertility treatments for conceiving are growing. Since the birth of Louise Brown in 1978, more than 5 million children have been born by fertility treatments in the last 40 years worldwide (5). The etiology of infertility is multifactorial and may include female factors such as anovulation and mechanical issues as well as male factors, mainly abnormal sperm count or function. Yet, male infertility accounts for 30–55% of infertility among couples (6).