The Testis

Testis 1 - Dr. Sakkas


Development of the Testis

  • Gonads are bipotential for first 7 weeks of gestation

  • Y chromosome is essential for sex determination and gonadal differentiation

  • SRY portion is the genetic determinant of maleness

  • SRY gene encodes for Testis Determining Factor (TDF) that promotes the Mullerian Inhibiting Factor (MIF; AMH)

  • Ovary is default pathway when TDF is not present


Spermatogenesis 

  • Sperm are released into the seminiferous tubule to go into the vas deferens and epididymis

  • Dramatic change in shape and form during period of spermatogenesis

  • Sertoli cells line the walls of seminiferous tubules from the basal portion to the lumen

    • Sertoli cells are the framework of seminiferous tubules

    • Developing sperm migrate from the basal layer to the lumen to then be released into the vas deferens and epididymis

  • Seminiferous tubules coordinate spermatogenesis


Key Cells in the Testis

Sertoli Cells

  • Forms the framework of seminiferous tubules

  • Testicular equivalent to granulosa cells

  • Produces inhibin to regulate FSH production 

  • Support and protect spermatogonia, phagocytize degenerating spermatogonia/spermatocytes

  • Produce nutritive fluids such as proteins, enzymes, RNA, and ions

  • Constantly talking to germ cells to regulate function of those germ cells through their development

  • What you have up until puberty is what you end up with → no stem line for Sertoli Cells

  • Forms blood-testis barrier

Leydig Cells

  • Interstitial endocrinocytes

  • Located between seminiferous tubules that are vital for testosterone production

  • Not many, important for their function

Germ Cells

  • Spermatogonia 


Blood-Testis Barrier

  • Sertoli cells have specialized tight junction

  • Spermatogonia and early spermatocytes lie outside of these tight junctions and the remaining germ cells lie inside the testis-tubule barrier (delineation of spermatogenesis as sperm develop that protects the sperm as they are developing)

  • This barrier acts to exclude potentially damaging agents such as antibodies and toxins


Endocrine Function

  • Leydig cells are primarily responsible for the majority of androgen production in the body

  • 95% of testosterone circulating in the male bloodstream originates from Leydig cells

  • Male fertility depends on the endocrine and paracrine functions of androgen produced by the testes via the hypothalamo-pituitary-testicular axis

Key Hormones

  • LHRH (LH releasing hormone)

  • LH

  • FSH

  • Testosterone

  • Inhibin


Feedback Mechanisms

  • Where the action of a hormone increases/decreases the effect of another hormone on itself

  • LH stimulates Leydig cells to produce testosterone and testosterone levels regulated via negative feedback mechanism

  • FSH stimulates Sertoli cells to produce inhibin and inhibin levels regulated via negative feedback mechanism


Testosterone

  • Produced by Leydig cells, regulated by LH

  • After birth, androgen secretion remains low until puberty, while testosterone secretion recommences in response to increased stimulation by LH

  • Is secreted in a pulsatile manner in response to pulsatile LH released by the pituitary gland 

  • Circulating testosterone acts via androgen receptors located in target cells to stimulate secondary characteristics and exert negative feedback regulation of LH secretion

  • Free testosterone: circulates in the plasma

    • In the blood, unbound to binding proteins

Targets

  • Vocal cords: voice deepening

  • Skin and fair follicles → hair on arms, legs, face

  • Bones: get stronger

  • Skeletal muscles: get stronger

  • Central Nervous System: different reactions could relate back to hormonal activity


Inhibin

  • Exerts a negative feedback regulation of FSH secretion before puberty

    • Putting a brake on FSH secretion

  • Along with testosterone, participates in the homeostatic control of circulating plasma FSH levels

Spermatogenesis

  • Complex process of proliferation and differentiation transforming spermatogonia into mature spermatozoa

  • Involves a series of mitosis and meiosis and changes in both cytoplasmic and nuclear architecture

    • Occurs to control the shape change of sperm 

  • Outcome of spermatogenesis affected by the extent of programmed cell death

    • Apoptosis attempts  to control numbers and quality of sperm produced

Mitosis

  • Increases cell numbers by division

  • End with two identical cells

    • Start with diploid, end with diploid

  • One cell will replenish the pool for spermatogensis later on, while the other undergoes spermatogenesis (spermatocyte development)

  • Spermatogonia are diploid (2N = 46) at base of tubule (basal side)

  • Cell division produces more diploid spermatogonia

  • Spermatogonia (2N) become primary spermatocytes

  • The spermatogonia that is dedicated to to spermatogenesis is termed spermatogonia Tybe B


Meiosis

  • Halves the chromosome number and generates genetic diversity

  • 1 primary spermatocyte (2N) divides to produce 4 haploid (N = 23) spermatids

  • Spermatids all equal in size and very small

  • During first round of meiosis (M1) centromeres do not divide (2n)

  • During M2, centromeres divide, result in N


Testis I


Intro

  • Mobile, particular shape, head and tail

  • All cellular events that occur to make a cell are occurring in sperm

  • In mammalian species, sperm production occurs at a lower than core body temperature, more efficient, many males have low hanging / positioning of balls

Development of the Testis

  • Gonads are bipotential for the first 7 weeks → no differential between the tissues

  • 1959: Y chromosome in mammals was essential for development as a male

  • 1991: Small fragment of the Y chromosome (SRY) was shown to be the genetic determinant of maleness

    • Encodes for the Testis Determining Factor

    • TDF: protein that promotes the Mullerian Inhibiting Factor (AMH/MIF/MIS)

  • TDF Absent = Ovary

  • TDF Present = Testis → testosterone and MIF production

Ducts

  • Default mechanism = Mullerian ducts, fallopian tubes, uterus

  • With SRY Gene activation, MIF, and TDF

    • Mullerian ducts are inhibited, and broken down. Wolffian duct go on to form the epididymis and vas deferens

  • Epididymus wraps around testis, vas deferens

  • Seminal plasma and seminal vesicle prostate gland

  • Sperm-producing tube have rings of tubules (seminiferous tubules within testis), that lead to the epididymis and vas deferens, which pools into the seminal vesicle, prostate gland

    • In all seminiferous tubules → spermatogenesis occurs from the basal area into the tubule area

    • Lumenal area, basal area, interstitial area between seminiferous tubules

  • Larger/mature cells and nuclei from the outside of the tubule

  • Development

    • Spermatogonia → spermatocytes → early/round spermatids → elongated spermatids → mature spermatozoa/sperm

    • Must be coordinated in hormonal and cell function fashion

  • Once sperm matures, it is released into the vas deferens and epididymis 

  • Sertoli Cell: goes from the lumenal to basal wall, framework of the seminiferous tubules

    • Seminiferous tubules help coordinate spermatogenesis → happens along the walls of the Sertoli cells

    • A lot of connective tissue around the seminiferous tubules, particular cells between the tubules that are important for testosterone production

Key Cells in the Testis

  • Leydig Cells: reside outside/between the seminiferous tubules, interstitial endocrinocytes

    • Key cells for producing hormones (testosterone)

    • Constitute less than 1% of the total testicular mass

    • Originate from 2 sources → differentiation from mesenchymal cells and from the division of Leydig cells under the influence of LH and FSH

  • Sertoli Cells: testicular equivalent to ovarian granulosa cells, sperm producing cells

    • Produce inhibin

    • Feed and regulate spermatogenesis along the testicular seminiferous wall

    • Support/protect spermatogonia, phagocytize (bit of a macrophage) degenerating spermatogonia / spermatocytes

    • Produce nutritive (protein, enzyme, ions) fluids and feed sperm

    • Do not divide in the adult testis, no extra Sertoli cells developing post-puberty

    • Form blood-testes barrier: sperm are antigenic

      • → don’t want to create a cell that can be phagocytosed by other cells, protects sperm when entering female reproductive tract so they won’t be seen as foreign enemies

      • Sertoli cells have specialized, tight junctions

      • Spermatogonia and early spermatocytes lie outside and the remaining germ cells lie inside the testis-tubule barrier

      • This barrier acts to exclude potentially damaging agents such as antibodies and toxins

        • Important the tight junction is intact

    • In constant contact with germ cells to regulate function/development of sperm

  • Endocrine Function

    • Occurs in the compartment between the tubules

    • Leydig cells are primarily responsible for the majority of androgen production in the body 

    • 95% of the testosterone circulating in the blood originates from Leydig Cells

      • Although there are few of them, very integral to function


Hypothalamus-Pituitary-Testicular Axis (HPT)

  • Male fertility depends on the endocrine and paracrine functions of androgens produced by the testes

Hormones

  • Reproductive messenger throughout the body, particular in how they deliver their message

  • Steroids, proteins, glycoproteins, or peptides

  • All hormones, regardless of structure, work through receptors that are normally outside the cell but can also be intracellular

    • Nuclear receptors exist for some hormones

  • The chemical structure of the hormone determines how and which receptor it activates

  • Lock and key theory → cells contain specialized receptors

  • LHRH: Luteinizing hormone-releasing hormone

  • LH: Luteinizing hormone     FSH: Follicle Stimulating Hormone

  • Testosterone     Inhibin

  • Feedback mechanism: action of a hormone increases or decreases the effect of another hormone or itself

AXIS EXPLAINED

  • The hypothalamus controls the posterior and anterior pituitary

  • FSH will trigger a response from the Sertoli cell

    • Inhibin will inhibit hypothalamus activity, looping back

  • LH will trigger a response from the Leydig cell, inhibiting testosterone production by sending negative feedback to the hypothalamus.

    • Will produce testosterone to activate Sertoli cell, but also alert the hypothalamus to halt production

Testosterone

  • Produced by the Leydig cells and regulated by LH (feedback mechanism)

  • Activated by maternal HCG during fetal and neonatal life

    • HCG and LH are very similar, can share receptors, combined to each others receptors

  • After birth, androgen secretion remains low until puberty, when testosterone secretion recommences in response to increase stimulation by LH → puberty 

  • Is secreted in a pulsatile manner in response to pulsatile LH released by the pituitary gland 

  • Pulsatile manner is more efficient in regulating hormonal activity and the feedback mechanisms

  • Biosynthesized from cholesterol, obtained from blood-borne high-density lipoproteins

  • Circulating testosterone acts via androgen receptors located in target cells to stimulate secondary characteristics and exert negative feedback regulation of LH secretion

    • Responsive target cells: vocal cords, skin/hair follicles, bones, skeletal muscles, central nervous system (brain)

    • Can be used to explain differences in metabolism, brain function → attributed to hormones

  • Binding proteins bind remainder of the testosterone circulating in your body

  • Free testosterone is what is important

Inhibin

  • Exerts a negative feedback regulation of FSH secretion before puberty

    • Putting a brake on FSH, Sertoli Cell

  • Along with testosterone, participated in the homeostasis control of circulating plasma FSH levels

Hypogonadotropic Hypogonadism: low testosterone with LH and FSH


Spermatogenesis

  • Complex process of proliferation and differentiation transforming spermatogonia (circular) into mature spermatozoa (small head long tail)

  • Unique process involves a series of mitoses and meioses and changes in both cytoplasmic and nuclear architecture

  • Outcome of spermatogenesis is affected by the extent of programmed cell death (apoptosis)

    • Control #/quality of sperm produced through apoptosis

  • Spermatocytes, just outside the blood-testes barrier, delineation of the sperm germ cells that squeeze through tight junctions and become early spermatids

  • Mitosis in the spermatogonia

  • Meiosis occurring in spermatocytes to round spermatids

  • Differentiation in the elongated spermatids to the mature spermatozoa 

  • Sertoli cells creating concert of exchange that allows spermatogonia to progress to mature spermatozoa

Tight Junctions

  • Series of protein that form the zip-like structure between cells

  • Preclude anything from passing between those cells, can control

  • Cells can squeeze through, closed above it and open below it to pass through

Kinetics of Spermatogenesis

  • Man → 64 days    Bull → 54 days  Ram → 49 days   Boar → 34 days   Rat → 48 days


Mitosis

  • Increases cell numbers by division

  • Dedicate one cell to the spermatogenesis pathway and retain one cell for spermatogenesis later on in life

  • Duplicated cells

  • Cell division, chromosome replication, and chromosome segregation

  • One will replenish the pool of spermatogenesis while other will go through the process of maturation

  • Spermatogonia (diploid) (2n=46). At base of tubule

  • Cell division produces more diploid spermatogonia

  • Spermatogonia (2N) become primary spermatocytes (2N)

    • Spermatogonia type A1 → 1 of them becomes spermatogonia type B → becomes spermatocyt

Meiosis

  • Halves the chromosome number and generates genetic diversity

  • 1 primary spermatocyte (2n) divides to produce 4 haploid (N=23) spermatids

  • Spermatids all equal in size and very small

  • Secondary spermatocyte goes through M2 to produce round spermatid

  • Start with 1 spermatocyte, end with 4

  • In M1 → centromeres do not divide, maintaining 2N

    • Telophase: 2N, same # of chromosomes

  • M2 → centromeres divie, all four have 1 N

    • Interphase II: division, separating into true haploid cells





Testis II - Dr. Sakkas


Sex Chromosomes

  • Male sperm brings the sex capabilities to the oocyte for sex determination of the offspring

  • Oocyte will always contribute an X while sperm can contribute X or Y

Spermiogenesis

  • Final stage of spematogenesis

  • Spermatids develop morphological traits of a sperm cell

  • All changes that take place during spermiogenesis are accomplished without any new gene expression or protein synthesis, since spermatids lack transcription and translation machinery 

  • No further changes in nuclear consistency (remains as a haploid cell), but changes in the shape to a more streamlined cell to better suit motility

  • Tail structure and nuclear compaction to create smaller head

  • Once the nucleus is heavily compacted, DNA replication, transcription, and translation are suppressed

DNA Packaging

  • Histone packaging to create nucleosomes that form chromosome

  • Protamine 

    • In sperm DNA packaging, the histones are taken away during spermiogensis and replaced with the nuclear protein called protamine

    • Protamine creates a tight packaging system to promote smaller head and tail of sperm

  • Improper DNA packaging can result in inheritance errors (epigenetic, RNA modification)

Regions of Mature Spermatozoa

Acrosome (cap): holds digestive enzymes for fertilization

  • Outer membrane to the head

  • Has various receptors that bind during the process of fertilization

Head (nucleus): stores DNA

Mid-piece (mitochondria): source of ATP

  • Provides energy to get the tail to move

Flagellum (tail): locomotion


Loss of Cytoplasm

The Sertoli cell has a macrophage-type property with a continual cross-talk with the sperm cells

  1. Sperm develop along the walls of the Sertoli cells

  2. Large plastic droplets are starting to be sucked into the Sertoli cells

  3. Shape of the sperm is being formed

    1. Sertoli cells are acting like macrophages by sucking in part of the cells

  4. Extra cytoplasm is sucked in by the Sertoli


Male Infertility

  • Recognized as the single most common cause of infertility, with sperm defects accounting for around 30-50% of cases presenting to fertility clinics

  • Semen analysis: prepare sperm, looking for motility count, and shape of sperm

  • WHO: reference values of male infertility

    • Sperm numbers < 15 million/mL

    • Total motility < 40% motile

    • Morphology < 15% normal shape 

  • Combinations of problems

    • Oligozoospermia: low numbers of sperm

    • Asthenozoospermia: poor motility

Types

  • Azoospermia: no sperm presence of sperm in ejaculatory duct

  • Obstructive Azoospermia: Testis functions properly to make sperm, but there is a “road block” in terms of allowing the sperm out

    • Easy to treat by surgically removing sperm

  • Non-Obstructive Azoospermia

    • Two most common categories of genetic factors associated with non-obstructive azoospermia: Chromosomal abnormalities + Y-Chromosomal microdeletions 

  • Spermatogonia present but no progress in spermatogenesis

  • Many patients opt for sperm donors


Intracytoplasmic Sperm Injection

  • Pioneered in 1992

  • Sperm is taken up in a pipette → oocyte

  • Tapping sperm tail renders sperm immotile, won’t run away

  • Must break cytoplasm of the oocyte for efficient injection of sperm

  • Only need one sperm per oocyte → efficient


DNA Damage in Sperm and Aging

  • Increased paternal age associated with adverse outcomes for offspring

    • Live pregnancy rate declines

    • Potential association with autism


Key Process

  • Acquisition of the sex chromosome

  • Oocyte will carry x and sperm will carry x or y

  • In addition to adding genetic diversity during meiosis, you also have allocation in the haploid cells of x or y, brings sex capabilities to the oocyte

  • Fluorescence in Situ Hybridization

    • Old tech used to look at chromosomes in sperm

    • Meiosis in spermatogenesis is quite efficient in comparison to the oocyte

Spermiogenesis 

  • Final stage of spermatogenesis (differentiation phase)

  • Further maturation

  • Develops morphological traits of a sperm cell

  • No growth phase, lose a lot of cytoplasm, becomes a tiny cell as they are more efficient at locomotion

  • Not moving yet

  • Zinc ions and different compositions in the tubular fluid activate it to be mobile

  • These changes are accomplished without any new gene expression or protein synthesis since spermatids lack transcription and translation machinery

    • No further change in the nuclear consistency, stays as haploid cell

  • Change in shape to a more streamlined cell better suited to motility

  • Acquisition of tail structure

  • Nuclear compaction: lacks big head, small compacted head

  • Microvilli become concentrated to one side of the cell, allowing motility capability

  • DNA is compacted in mammalian sperm, lack large nucleus, easier to maneuver

    • DNA is normally packaged in histone packaging (large of gaps), all cells are virtually packaged in this way, efficient system as DNA forms histone octamers that form chromosomes

  • In sperm, histones are taken away and replaced with protamine, creating a more efficient packaging system, chromatin develops doughnut structures

    • Allows you to gain 1/40 volume with protamine packaging

    • Sperm nuclear compaction, tight chromatin, very little information can move

    • Some molecular organizing regions that are necessary to allow the protamine to decondense once fertilization occurs

  • If packaging is not correct, inheritance errors can occur, not transcriptional. 

  • Epigenetic inheritance of acquired traits through sperm RNAs and sperm RNA modifications

    • Epimutations induced through affects on the chromosome (X-rays and environmental)

    • Other form of inheritance: Sperm acquire some traits and RNA’s as they pass through the male reproductive tract through RNAs through extracellular vesicles that contain regulatory RNAs

  • Occurring in the testis, certain temporal distribution of types of RNAs that during the maturation process in the epididymis which allow some traits to be inherited

  • May translate to some RNAS being available to help the embryo develop

  • May be an association with paternal age and perinatal outcomes

    • More adverse events when father is older regardless of maternal age

    • Small gestational babies, prematurity

    • Older fathers may be more prone to fathering children with neurodegenerative disorders, small increases

    • Some concern as the male ages, sperm is not protected from aging process


Sperm

  • Specialized membrane that surrounds the head

  • How mitochondria provides energy for the tail to move, particular structure of tail

Regions of mature spermatozoa

  • The acrosome (cap): holds digestive enzymes for fertilization, special membrane. Receptors that bind during the process of fertilization

  • Head (nucleus): stores DNA

  • Mid-piece (mitochondria): source of ATP

  • Flagellum (tail): locomotion

  • Good sperm: nucleus is very dark, condensed, traits of membrane surrounding it, midpiece is slender

  • Bad sperm: nucleus is gray, patchy. Midpiece is swollen

  • Loss of cytoplasm: Sertoli cell macrophage property, cross talk with sperm cells

    • As sperm develops, cytoplasmic droplets aggregates around sperm are sucked into the Sertoli cell

    • Symbiotic relationship between sertoli cell and developing sperm is important in controlling structure and differentiation of sperm

  • Particular microtubule pattern: important in allowing sperm to create motility

    • 9+2 microtubule pattern, general structure, allows normal motility

  • Zona pellucida proteins become very important and allow binding to the egg

  • During epididymal maturation, stabilization and fertilization proteins that are occurring in the membrane that allow for fertilization, movement, interaction with female reproductive tract, cells surrounding the egg and the zona pellucida

  • Specific capacitation: modifications in the sperm membrane readying for fertilization that allow for greater motility, one sperm is favored to reach the egg

  • Cellular, genetic and chromatin changes at the different stages of spermatogenesis and sperm cell maturation are all important in allowing the sperm to gain the characteristics for fertilization and normal development

  • Translation, transcription, and recombination happen during early stages but are suppressed once the nucleus is heavily compacted

  • As sperm passes through reproductive tract, acquiring epigenetic characteristics that allow it to give certain traits to the offspring

  • Delivery of RNAs present in human sperm

    • Some RNAs appear to be important for the early stages of embryonic development

    • Early embryo mostly driven by maternal messenger RNA in the oocyte, indication that there are some factors that sperm bring along (paternal RNAs) that influence development

Fertilization

  • Key event during spermatogenesis and spermiogenesis, want sperm nucleus to decondense and be protaminated

  • Once fertilized, want protamines to be replaced with histones to have normal histone, nucleated chromosome DNA.

  • Sperm entry

  • Male pronuclei decondensation 

    • Sperm enters the oocyte, want protamines to be taken out, histones to be replaced in. Mechanisms within the oocyte strip out protamines, nucleus is changed into a more histone-packed DNA

    • At same time, male proncelus has to find the female pronucleus. Sends out microvili actin fillaments to search for the female pronuclei, expanding out to draw in the pronuclei

    • Found pronuclei, both now decondensing and forming pronuclei

    • Syngamy: 2 haploid cells coming together to make a normal ploidy during fertilization

  • Imprinting: control on the x and y chromosomes of certain genes

    • Mostly done by methylation patterns, male pronuclei is very heavily methylated, remains methylated during gametogenesis

    • Difference in the fertilization and implantation process in both how the male and female gametes are methylated (male sex chromosomes)

    • Many genes controlled by this mechanism

    • Imprinting allows for the maintenance of certain genes to ensure that there aren’t traits that are affected by the x chromosome

Sperm

  • Different species have different lengths of sperm

  • Human: 65 micrometers, rounded

  • Mouse: 110 micrometers, most rodent species have a very characteristic beak

  • Drosophila fruit flies: very long, 58 millimeters

  • Whale: 56 micrometers



Spermatogenesis

  • The unique process can result in the production of up to 200 million spermatozoa daily

  • Very different from conservative activity that controls egg production

  • WHO: normal semen variables, created by following new couples trying to conceive

  • Healthy ejaculate

    • Successful pregnancies: total sperm count in ejaculate between 40 million or more → 928 million. 

    • Ejaculate volume: 1.5-7.6 ml

    • Sperm concentration, more than 15 million (15-259 million per mL)

    • Total motility: over 40% is moving (40-81%)

    • Progressive motility: 32-75% around 40%

    • Sperm morphology: more than 4% to have normal shape (4-48%)

      • Not as important compared to motility

  • Male Infertility: recognized as the single most common cause of infertility with sperm defects accounting for around 30-50% of cases presenting to fertility clinics

  • Semen analysis: count, motility, shape → assessment

  • Reference values for male infertility

    • Count: less than 15 million/ml (Oligozoospermia)

    • Total motility: less than 40% motile (Asthenozoospermia) 

    • Morphology: less than 15% normal forms (teratozoospermia)

    • Low numbers + poor motility is oligoasthenozoospermia

    • Low numbers, poor motility, and poor morphology: oligoasthenoteratozoospermia (OAT)

  • Azoospermia: obstructive

    • No sperm in ejaculate

    • Ejaculatory duct obstruction

    • Congenital bilateral absence of the vasa deferential → during the fetal development, vas deferens weren’t developed properly

    • There is a strong association between CBAVD and mutations of the cystic fibrosis transmembrane conductance regular CFTR

    • Treatment: surgically remove sperm

  • Azoospermia: non-obstructive

    • Chromosomal abnormalities resulting in impaired testicular function

    • Y-chromosome microdeletions leading to isolated spermatogenic impairment

    • Problem within spermatogenesis itself

      • Spermatogonia, but not moving forward to make elongated spermatids

      • Virtually impossible to treat

    • Certain genes called asospermic factor genes located on y chromosome

      • AZF A → Sertoli cell only patients

      • AZF B and C → spermatogenic arrest, indication of nonobstructive

  • Fertilization: mix sperm and egg together in vitro

  • Routine IVF: put about 100,000 sperm

  • Male factor patients, treat male factor infertility by taking single sperm and injecting it into the egg directly, 

    • Intracytoplasmic sperm injection (ICSI), first done in 1992

    • Pipette, 5-6 microns wide → Oocyte 135 microns wide

    • Egg membrane (oolemma) is so watery that you cannot tell where the egg is injected

    • Birth rates equivalent to regular IVF

    • First IVF pregnancy in 1978

    • IVF developed to treat women with blocked fallopian tubes

    • Micromanipulation techniques used to treat infertile men (subzonal insemination) (SUZI) partial zona dissection (PZD)

    • ICSI: More than 70% of cases worldwide are done using ICSI

Sperm Nuclear Determinants of Reproductive Outcomes

  • Aneuploidy, y-chromosome microdeletions, epigenetic 

  • Abnormalities in the sperm

    • Can impact fertilization, embryo development

    • Pregnancy loss: could be related to sperm

    • As male ages, the effects on sperm, live pregnancy rate drops

Advancing Paternal Age and Autism

  • Significant monotonic association between advancing paternal age and the risk of autism

  • Offspring of men 40 years or older were 5.75x more likely to have ASF compared with offspring of men younger than 40

  • Increase in DNA damage with age, increasing mutation rate

  • Strong indications with age

  • Paternal influence on fertilization, embryo development, pregnancy, fertility, future generations