Function and structure of cilia in the fallopian tube of an infertile woman with Kartagener's syndrome

In Kartagener's syndrome (KS), primary defects of the ciliary axoneme causedyskinetic ciliary motion. Because ciliary motion is an important factor innormal ovum transport, ciliary dyskinesia may cause infertility. On theother hand, the existence of some ciliary activity, albeit abnormal, mayaccount for fertility in some women with KS. In this case study, aninfertile woman diagnosed with KS had normal results in all usualinfertility tests. Biopsies of tubal mucosa were obtained at laparoscopyfor ovum recovery during an in-vitro fertilization cycle. Ciliary activity,measured by laser light- scattering spectroscopy, was detected in all tubalspecimens; however the majority of regions sampled showed no activity. Inactive regions, beat frequency ranged from 5 to 10 Hz, approximately 30% ofnormal. Electron microscopy showed similar morphological defects in bothtubal and nasal mucosa. The number of cilia per cell was approximately 20%of normal. The major ultrastructural abnormality of cilia was an absence ofthe central microtubules. The only demonstrable explanation for thispatient's infertility was primary ciliary dyskinesia associated with KS.