Role of sperm DNA damage in creating de-novo mutations in human offspring: the 'post-meiotic oocyte collusion' hypothesis.

Spermatogonial stem cells exhibit a low level of spontaneous mutation that is heavily impacted by paternal age via mechanisms that appear to involve the aberrant repair of DNA damage. This background de-novo mutation frequency can be increased 1000-fold by mutations affecting a key signal transduction pathway that confers upon its descendants a selective advantage, leading to clonal expansion and nests of mutant germ cells in the testes of ageing males. This 'selfish selection' model effectively explains the origin of several dominant developmental disorders, such as achondroplasia and Apert syndrome, but cannot be generalized to account for the majority of de-novo mutations where no selective advantage is apparent. In this article, an additional germline mutation pathway is proposed that recognizes the unique susceptibility of spermatozoa to DNA damage and the importance of the oocyte in repairing these lesions prior to the S phase of the first mitotic division. Any deficiency or inaccuracy on the part of the oocyte in effecting this repair process has the potential to fix paternal DNA damage as a de-novo mutation in the embryo. Such a mechanism supports emerging data indicating that assisted conception procedures may enhance the mutational load carried by ART offspring.