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The National Survey of Australian Secondary Students and Sexual Health (SSASH) is a periodic survey of sexual health among school-aged young people in Australia. The survey began in 1992 and, in this report, we present findings from the seventh iteration. The SSASH survey reports on a range of issues related to sexual identity and experiences, STI and HIV prevention, and relationships and sexuality education (RSE) and provides information about the progress of key priority areas in the Fourth National Sexually Transmissible Infections Strategy (Australian Department of Health, 2018).

This thesis examines the effect of ageing on the DNA repair capacity of oocytes by studying the expression of oocyte DNA repair genes and DNA damage response (DDR) in an in vitro fertilisation (IVF) experimental model using controlled levels of sperm DNA damage. It also examined the effect of male and female age on the clinical outcomes of couples presenting with idiopathic infertility at an IVF clinic. The current findings suggests that ageing results in a diminished oocyte DNA repair capacity to amend DNA damage or paternal origin. In the clinical setting, this thesis also showed that male ageing is negatively associated with the clinical outcomes of ARTs in couples with idiopathic infertility independent of female age.

A nationwide ‘Sleep-On-Side When Baby’s Inside’ public health campaign was initiated in New Zealand in 2018. This was in response to evidence that maternal supine late pregnancy going-to-sleep position was an independent risk factor for stillbirth from 28 weeks’ gestation. We plan to evaluate the success of the campaign through two nation-wide surveys of 1) pregnant women in the third trimester and 2) health professionals who provide care for pregnant women.

This thesis sought to examine the interplay of key molecular processes involved in the pathogenesis of cancer. Ground-breaking re-emergence of Nodal/Cripto was detected in endometrial cancer patient samples compared to healthy controls. Interestingly blockade of Nodal/Cripto activities, using monoclonal antibody treatment significantly reversed the carcinogenic behaviour of cellular models. This thesis also examined another molecule, with important functions within the female reproductive tract, the Interferon Epsilon. It was demonstrated that Interferon Epsilon treatment of aggressive endometrial cancer cells dramatically reduced cell growth. These findings could be utilized in the potential development of novel therapeutic agents for endometrial cancer.

Supplemental Tables S1-S5 from:Toll-like receptor-4 antagonist (+)-naloxone elicits sexually dimorphic attenuation of inflammation-induced fetal programming in miceChin P-Y, Dorian C, Sharkey DJ, Hutchinson MR, Rice KC, Moldenhauer LM, Robertson SA.

Polycystic ovary syndrome (PCOS) is associated with increased risk of adverse pregnancy and birth outcomes, however this may be most related to the conditions associated with PCOS rather than PCOS per se. Current evidence on pregnancy and birth outcomes is poor and uncertain, mostly due to inclusion of selected populations and inclusion of multiple outcomes of interest with different sort of risk factors and confounders. To address the knowledge gaps in this area, future research should target community-based women with medically diagnosed PCOS status and defined PCOS phenotype and should focus on pathophysiologically related outcomes at each study.

Most mammalian testes originate in the stomach then descend during early life to reside in the scrotum, where the temperature is 2–7 °C lower than the body temperature. Elevation above the scrotal temperature can cause the death of the heat-sensitive spermatogenic cells. Although the physiological and cellular responses of the testes to heat stress have been well established, the molecular mechanisms that control these responses remain mostly unknown. In this thesis, the impact of heat on genes and proteins in the testis was investigated using two different heat exposure models: acute mild heat and surgical translocation to the abdomen in the adult rat. These studies have identified a number of molecules that are affected by the heat in the testis.

Oxygen free radicals are created during the IVF process. These have the potential to damage DNA in human eggs and embryos thereby reducing pregnancy rates after IVF. Melatonin has the ability to reduce the effects of oxygen free radicals. In the Melatonin in Assisted Reproductive Technology trial, I found that, while oral melatonin can increase levels of melatonin in follicular fluid, this does not significantly improve IVF success rates.