Pathogenic gain-of-function mutations associated with increased paternal age, albeit harmful to embryonic development, are paradoxically enriched in the normal testis. Evidence from previous studies indicates that these so-called paternal age-effect mutations confer a proliferative advantage to the spermatogonia in which they arise, leading to clonal expansion within the normal testis over time. Recently, spermatocytic seminoma (SS; a rare testicular germ cell tumour that occurs mainly in older men) has emerged as a key link between the processes of somatic and germline mutation (Goriely et al, Nat Genet. 41:1247-52, 2009), suggesting that the proposed clonal expansion events can in some cases lead to testicular tumourigenesis. In this thesis, I have used immunohistochemistry to seek evidence for putative clones of cells in the normal adult testis. To address this, a screening approach was developed using markers chosen from analysis of normal testicular tissues and SS. The ontogeny of OCT2 and SSX expression in human testis, from embryonic development to adulthood, identified distinct subpopulations of spermatogonia at different maturation stages. Together, these data reveal the potential of OCT2 as a novel marker of A_dark spermatogonia (human reserve spermatogonial stem cells). In parallel with these observations, two distinct types of SS characterised by differential OCT2 and SSX immunoexpression were identified, providing new evidence for heterogeneity of this tumour. This work provided the backdrop to the detailed immunohistochemical study of normal adult testis by characterising in serial sections the expression of five spermatogonial markers, MAGEA4, SSX, FGFR3, OCT2 and SAGE1, and a proliferation marker, Ki67. Independent sections were screened with predetermined criteria set to identify unusual positively-stained cellular clusters within the seminiferous tubules. Several antigenic combinations previously described in SS were observed in a subset of these clones, suggesting differing genetic origins and a possible link with early events of testicular tumourigenesis. The size (minimum number of cells) of each clonal event was estimated and its correlation with the staining pattern of the molecular markers was investigated. In summary, the data presented in this thesis convincingly identify for the first time the previously hypothesised clonal events in the testis using immunohistochemical markers. My research will pave the way for future work involving genetic analysis of microdissected cells from these putative clones, aimed at identifying the underlying mutational events thought to be present.

The purpose of this thesis is to investigate the link between advanced paternal ages (APA) (i.e., APA ≥ 35 years and APA ≥ 50 years) and genetic diseases and congenital anomalies. Currently, the relationship between both advanced paternal ages and genetic diseases and congenital anomalies remains unclear. However, there is room for improvement to systematically investigate the relationship between specific congenital anomalies in newborns and advanced paternal ages. More recently, the link between advanced paternal age (as opposed to existing studies analyzing advanced maternal age alone) and genetic diseases has been recognized by researchers, epidemiologists, and various health experts. Thus, this study serves to examine the effect of advanced paternal ages on the likelihood of birth defects using a new dataset intended to discover those relationships. I create three different datasets and utilize 12 statistical models to analyze the relationship between advanced paternal ages (APA ≥ 35 years and APA ≥ 50 years) (while including advanced maternal age or AMA [AMA ≥ 35 years]) and genetic diseases and congenital anomalies. I focus on Down syndrome, cleft lip with or without cleft palate, and meningocele/spina bifida and explore the relationship between both advanced parental ages. I explore whether (a) the advanced paternal ages and (b) the advanced maternal age increase the likelihood of newborn reproductive defects: (a) Down syndrome, (b) cleft lip with or without cleft palate, and (c) meningocele/spina bifida. This study includes all U.S. births between 2016 and 2019 using the CDC Natality Registry[1] database (2020). I perform the analyses using logistic regression models (to estimate odds ratios) that provide explanations of the relationship between each birth defect and advanced paternal ages. Analysis results suggest that advanced paternal ages (APA ≥ 35 years and APA ≥ 50 years) are positively associated with Down syndrome, whereas advanced paternal age (APA ≥ 35 years) is negatively associated with cleft lip with or without cleft palate. The results from the advanced paternal ages models do not suggest any causal relationship/effect on spina bifida. The results of this study are expected to offer some insight of the following reproductive defects: (a) Down syndrome, (b) cleft lip with or without cleft palate, and (c) meningocele/spina bifida. [1] Collection of data for all variables used in this research are obtained with full permission from: United States Department of Health and Human Services (US DHHS), Centers for Disease Control and Prevention" "(CDC), National Center for Health Statistics (NCHS), Division of Vital Statistics, Natality public-use data 2016-2019, on CDC" WONDER Online Database, October 2020. Accessed at http://wonder.cdc.gov/natality-expanded-current.html on Jun 6, 2021, 1:24:47 PM;" United States Department of Health and Human Services (US DHHS), Centers for Disease Control and Prevention" "(CDC), National Center for Health Statistics (NCHS), Division of Vital Statistics, Natality public-use data 2016-2019, on CDC" "WONDER Online Database, October 2020. Accessed at http://wonder.cdc.gov/natality-expanded-current.html on Jun 6, 2021, 1:29:36 PM;" And United States Department of Health and Human Services (US DHHS), Centers for Disease Control and Prevention""(CDC), National Center for Health Statistics (NCHS), Division of Vital Statistics, Natality public-use data 2016-2019, on CDC" "WONDER Online Database, October 2020. Accessed at http://wonder.cdc.gov/natality-expanded-current.html on Jun 6, 2021, 1:07:36 PM."

Abstract There is an extensive literature on advanced paternal age (APA) as a risk factor for a wide variety of adverse health outcomes in the offspring that occur throughout the lifespan. APA is also a well-replicated and relatively robust risk factor for schizophrenia in the offspring. The aim of this study was to investigate advanced paternal age (APA) as a risk factor for schizophrenia and mortality in the offspring in four perspectives and original publications. The Northern Finland 1966 Birth Cohort (NFBC 1966) consists of 12,068 pregnant women with expected dates of delivery in 1966, and their 12,058 live-born children. The data used here were collected prospectively for 11,058 singleton-birth cohort members who were living in Finland at age one. The Helsinki 1951–1960 Schizophrenia Cohort consists of 529 persons born in Helsinki, Finland, between January 1, 1951 and December 31, 1960, who developed nonaffective psychosis before 1999. The Finnish Nonaffective Psychosis Cohort (Finnish NAP Cohort) consists of all 13,712 persons born in Finland between 1950 and 1969, who developed nonaffective psychosis before 1992. Both APA (≥30) and younger paternal age (<25) increased the risk of schizophrenia; younger paternal age may be associated with an increased risk in males but not females. In the general population, APA was associated with increased all-causes mortality and suicide in females but not males. Within NAP, in females but not males, there was a significant increase in all-causes mortality and natural deaths in offspring of fathers age ≥40. In both the general population and within NAP, APA was associated with having a mother with schizophrenia. An understanding of APA has substantial public health potential, as average paternal ages are increasing, and APA is common, has widespread effects, and is potentially preventable. We have provided important information for future epidemiological and clinical studies of all conditions associated with APA. Accounting for the APA effect as a potential confounding factor may also increase the signal-to-noise ratio in other epidemiological and genetic analyses. Our results have generated new and more refined hypotheses regarding psychosocial and/or biological mechanisms of the APA effect, and lay the foundation for animal models for its mechanism of action. Subsequent studies will be important to clarifying the pathophysiology of a potentially preventable determinant of schizophrenia and mortality. / Tiivistelmä Isän korkean iän (advanced paternal age, APA) on havaittu olevan yhteydessä laajaan kirjoon eri terveysongelmia. Aiemmassa tutkimuksessa havaittiin APA:n liittyvän tyttärien ylikuolleisuuteen, mutta pojilla vastaavaa yhteyttä ei havaittu. Tätä yhteyttä ei ole aiemmin tutkittu väestöpohjaisessa otoksessa. APA:n on myös havaittu olevan yksi skitsofrenian riskitekijöistä, mutta vaikutuksen suuruutta sairastumisriskiin, mahdollisia sukupuolieroja, kliinisiä piirteitä tai yhteyttä kuvantamislöydöksiin ei tunneta. Tämän tutkimuksen tarkoitus oli selvittää APA:n vaikutusta lasten skitsofreniariskiin ja kuolleisuuteen. Pohjois-Suomen vuoden 1966 syntymäkohortti (Northern Finland 1966 Birth Cohort, NFBC 1966) käsittää 12 068 raskaana olevaa naista ja heidän 12 058 elävänä syntynyttä lastaan. Tässä tutkimuksessa käytetty tieto on kerätty prospektiivisesti 11 058 kohortin jäsenestä, jotka asuivat Suomessa yhden vuoden ikäisinä eivätkä olleet kaksosia. Helsingin vuosien 1951–1960 skitsofreniakohortin 529 Helsingissä 1951–1960 syntynyttä jäsentä seurattiin tätä tutkimusta varten prospektiivisesti kesäkuuhun 2006 asti. Suomalaiseen psykoosikohorttiin (The Finnish Nonaffective Psychosis Cohort, Finnish NAP Cohort) kuuluu 13 712 psykoosia sairastavaa henkilöä, jotka ovat syntyneet 1950–1969. Sekä isän korkea (≥30) että nuori ikä (<25) lisäsivät riskiä sairastua skitsofreniaan. Isän nuori ikä näytti lisäävän riskiä ainoastaan pojilla. Yleisväestössä isän korkea ikä oli yhteydessä lisääntyneeseen kokonaiskuolleisuuteen ja itsemurhiin naisilla, mutta vastaavaa yhteyttä ei havaittu miehillä. Psykoosia sairastavilla naisilla isän ikä ≥40 oli yhteydessä lisääntyneeseen kokonaiskuolleisuuteen ja luonnollisiin kuolemiin. Yleisväestössä ja psykoosia sairastavilla korkea isän ikä oli yhteydessä äidin skitsofreniaan. Skitsofreniaa sairastavilla korkea isän ikä liittyi pitempään hoitamattoman psykoosin kestoon, huonompaan sosiaaliseen ja ammatilliseen toimintakykyyn sekä lisääntyneeseen päihteiden käyttöön. Tämä tutkimus vahvisti aiempaa käsitystä isän korkean iän yhteydestä kuolleisuuteen ja skitsofreniaan. Löydöksellä on mahdollisia kansanterveydellisiä vaikutuksia, koska keskimääräinen isän ikä on noussut ja on yleistä väestössä. Isän ikään on mahdollista vaikuttaa. Isän ikä on myös mahdollinen sekoittava tekijä tutkittaessa skitsofrenian kausaalisia tekijöitä ja kehityskulkuja.

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This doctoral thesis is devoted to the study of the effects of late fertility on health of the newborn and to the implications of late fertility in the fertility decision process. Late fertility is defined as the reproduction process after 30 years old. The interest lies as well from the maternal age point of view as from the paternal age point of view. The first part is devoted to the study of the determinants of infant morbidity and mortality with a particular attention to the parental age, without neglecting the other determinants. The originality of this part is located from the methodological point of view. We construct a structural model of infant morbidity/mortality in order to isolate the causal effect of late fertility. By a structural model we mean a model which represents a set of causal relationships represented mathematically by a multi-equation model and graphically by directed acyclic graphs. As a complementary approach, a chapter of the thesis is devoted to an exploratory model highlighting the role of the extreme values rather than average values traditionally of interest in most statistical analyses. Both methods are tested with Hungarian data: individual registration forms of livebirths and infant deaths (1984-1984 and 1994-1998), and the Hungarian case-control surveillance of congenital abnormalities (1997-2002). The second part analyses the effect of parental ageing in the fertility decision process. We try to determine whether the detrimental effect of late fertility on health of the child and on fecundity of the couples intervene in the preferences for a child. We assume that parental age influences the preferences for a child through effects on the desire for a child and on the beliefs in the capacity of reproduction of a healthy child. This hypothesis is tested using the data from the National Survey of Family Growth (United States, 2002) and from the Fertility and Family Survey (Hungary, Czech Republic and Belgium).

L'idée que les souches de rongeurs de laboratoire ne soient pas des modèles idéaux pour la recherche sur le vieillissement n’est pas nouvelle. Pourtant, l’attitude des chercheurs face à l’introduction d’animaux de type sauvage dans leurs travaux demeure frileuse bien que ces derniers apporteraient une solution adéquate pour l’étude d’un processus aussi complexe et multifactoriel que le vieillissement et permettraient d’intégrer les traits d’histoire de vie des individus afin de rendre compte de façon pertinente des changements liés à l’âge. Chez la souris glaneuse, le report de l’âge de première reproduction des animaux juvéniles hivernants conduit à la création de deux cohortes. Ces deux groupes d’animaux devront, à un âge plus ou moins avancé, explorer des environnements anxiogènes et faire face à des compétiteurs lors de leur dispersion, se reproduire et élever leur progéniture qui devra à son tour disperser. L’objectif de cette thèse est d’étudier les conséquences émotionnelles et sociales du vieillissement qui pourraient influencer les stratégies comportementales de ce rongeur de type sauvage. Ce travail s’ouvre également sur des thématiques d’actualité dans le domaine de la biogérontologie. Notre étude montre qu’à l’instar de celles réalisées chez l’Homme, le niveau d’anxiété d’un individu peut être déterminé par son âge mais aussi par l’âge de ses parents. L’âge de mise en couple va quant à lui influencer certaines stratégies liées à la reproduction comme la latence d’accouplement ou l’effort parental fourni par les mères et les pères et va conditionner l’apparition des premiers signes de sénescence reproductive. Enfin, cette étude dévoile que la durée de vie reproductive d’un couple monogame pourrait être un facteur renforçateur des liens qui unissent un mâle à sa partenaire. / The idea that standard laboratory rodents may not be an ideal model for aging research is not new. Nonetheless, the researcher's attitude toward using wild-type species remains cautious although these animals would make a suitable solution to study a process as complex and multifaceted as aging, and would allow to incorporate the life history traits of individuals to reflect appropriately age-related changes. In the mound-building mouse, the delay of the age of first reproduction of over wintering juvenile animals leads to the establishment of two cohorts. These two groups of animals have to, at more or less advanced ages, explore anxiogenic environnements and face competitors during dispersal, reproduce and raise their offspring wich will in turn disperse. The aim of this thesis is to study the emotional and social consequences of aging that could influence the behavioral strategies in this wild-type rodent focusing on current issues in the biogerontogical field. Our study shows that, like in humans, the anxiety level of an individual can be determined by its own age but also by the age of its parents at conception. For its part, the age at pairing influences reproduction-related strategies as the latency of first reproduction or parental effort provided by mothers and fathers and affects the appearence of the first signs of reproductive senescence. Finally, this work reveals that the duration of pairing could strengthen the social bond between a male and its partner in a monogamous species.