osteomed09
Forum Newbie
Topics: 5
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1. A young couple has been unable to achieve a viable pregnancy. Semen analysis shows normal quality and quantity of sperm. The woman has regular menstrual cycles and takes no contraceptives. Biopsy of her nasal sinus mucosa shows epithelial cells with the majority of cilia bent at half their length. The most likely functional cause for this couple's infertility is a deficiency in which of the following?
A) Capacitation of spermatozoa
B) Completion of meiosis by ovulated oocytes
C) Implantation into the uterus
D) Migration of conceptus
E) Mobility of spermatozoa
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| spjokes
Forum Senior
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Posts: 88
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It seems to be a case of Primary ciliary dyskinesia (Siewert's / Kartagener's Syndrome).
Can we think of any other condition?
To my knowledge though theoretically female infertility is also possible, however, until now there is no proof for this.
Please refer
http://www.p-c-d.org/en/faq/
PLEASE CORRECT ME IF I AM WRONG.
Some more information about PCD
In 1902, Siewert described a person with situs inversus and bronchiectasis. He could draw no connection between these two signs, however. Kartagener, in 1933, was the first to recognize a clinical syndrome of situs inversus totalis, bronchiectasis, and chronic sinusitis. The pathogenesis of primary ciliary dyskinesia began to come to light in 1975, when Afzelius described the absence of dynein arms in the tails of immotile sperm. A year later, Afzelius coined the term "immotile cilia syndrome", which remains prevalent in the literature. However, given that cilia are "dysmotile," but not "immotile," in many cases, many authors prefer the term primary ciliary dyskinesia (PCD). Afzelius and others presented evidence that a genetic defect of the gene(s) for dynein, leading to a congenital lack of dynein arms in cilia and sperm tails, was responsible for both the respiratory and fertility problems. They further hypothesized that the lack of ciliary movement in embryonal tissues resulted in random organ rotation, which would result in 50% of PCD patients having situs inversus.
Electron microscopy of mucosal cilia and sperm tails shows the absence of dynein arms. Since dynein is one of the key intra-cellular 'molecular motors' , the absence of the dynein arms is responsible for the impaired motility of the cilia and sperm.
DD: Youngs syndrome (bronchiectasis, sinusitis, and obstructive azoospermia).
Ciliary ultrastructure and function are normal in Young's syndrome, as well as in CF.
Diagnosis: Measurements of airway mucociliary clearance may be valuable screening tools for excluding PCD.
To confirm the diagnosis, biopsy of respiratory mucosa or microscopic examination of sperm is required.
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| robin082006
Forum Hero
Topics: 471
Posts: 5,123
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D
___________________
The Key to Succeed is Patience.
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| waqastariq
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dynein dysfunction leads to bending of the cilia...
and then there is a problem with conceptus migration from ampula where the zygote is formed to the uterine cavity which takes place in 6 days and then the implantation occurs...
increased incidence of ectopic pregnancy is also notes in these patients...which is tubal pregnancy...
thanks 
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| waqastariq
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option D
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| Cedrick
Esculapio
Topics: 324
Posts: 2,058
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confirmed
D.-conceptus can't move
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| mousa
Forum Senior
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u are correct guys
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