Columbia, SC (PRWEB) October 23, 2008
An infrequent condition in men, "Primary Ciliary Dyskinesia" (PCD) can cause sperm to loose their ability to move. Men with this condition are normally unable to conceive through intercourse.
When they could not conceive on their own, Ron Lyerly and his wife Kelly sought out the fertility expertise of Dr. Gail Whitman-Elia at Advanced Fertility & Reproductive Endocrinology Institute, LLC in West Columbia, SC.
The husband had several semen analyses that showed all non-motile sperm. His medical history, which included chronic bronchitis and recurrent pneumonia, indicated he may have a condition known as Kartagener's Syndrome. However, Kartagener's syndrome was ruled out following a pulmonary evaluation since the patient lacked situs inverus; instead, it was determined the patient has primary ciliary dyskinesia (PCD). PCD results in immotility of the cilia of the body including the respiratory tract and sperm tails.
The clinic collected semen samples from the patient for analysis and the results showed normal semen parameters except for sperm motility. A sperm viability test was used to confirm that 40% of his sperm were alive, even though they were non-motile. Advanced Fertility had another sample tested to confirm the sperm functioned properly by being able to undergo the acrosome reaction and penetrate the zona of an oocyte.
Under the research leadership of head embryologist, Richard Kordus, the morphology of the sperm looked normal under the light microscope, but electron microscopy, looked at the sperm tail's internal structure which showed abnormalities.
In a case report published in this month's Journal of Assisted Reproduction And Genetics, Kordus outlines his description of the ultrastructure of spermatozoa from this patient with complete asthenozoospermia that resulted in live births following blastocyst culture.
From electron microscope evidence, Kordus et al suggested that Mr. Lylerly has a dynein arm deficiency in the region of the sperm acrosome. Other research has shown that PCD is inherited in an autosomal or X-linked fashion. The couple proceeded with in vitro fertilization treatment at Advanced Fertility in late 2006. A hypo-osmotic swelling (HOS) technique was used by Kordus to select living sperm for injection into the oocytes. Five of the six oocytes injected fertilized normally and all five developed to the blastocyst stage of development. In consultation with clinic founder and reproductive endocrinologist, Dr. Gail Whitman-Elia, two of the embryos were transferred at the blastocyst stage producing a twin pregnancy. The other three embryos were cryopreserved and remain in storage.
The wife gave birth to healthy twin girls in 2007 and the couple is planning to proceed with a frozen embryo transfer in the near future. To the knowledge of the clinic, this is the first time a practice has used blastocyst culture in conjunction with a diagnosis of PCD and the HOS test resulting in an actual live birth.
Kordus was joined in this ground-breaking research by Robert L. Price, PhD, Research Professor, and Jeffrey M David, BS, Research Scientist, in the Instrumentation Resource Facility at the University of South Carolina.