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Table 1 A chronological summary of published cases on Kartagener’s syndrome and its management in the clinical context

From: Live birth after Laser Assisted Viability Assessment (LAVA) to detect pentoxifylline resistant ejaculated immotile spermatozoa during ICSI in a couple with male Kartagener’s syndrome

Report

Prognosis

Management

Outcome

von Zumbusch et al. [4]

Case1: sperm concentration 75 × 106/mL,

Case2: sperm concentration 210 × 106/mL, both total immotile

Diagnosed by eosin test and TEM, random sperm pick and fertilization by ICSI

Live birth of healthy twins (case 1) and a singleton (case2)

Abu-Musa et al. [35]

sperm concentration of 58 × 106/mL, total immotile

random sperm pick in ICSI

No fertilization and pregnancy

Kay et al. [5]

Mean sperm concentration of 49 × 106/mL, 25% mean motility

Diagnosed by TEM, fertilization by ICSI after gradient and swim-up

Live birth of a singleton male

Cayan et al. [14]

Case1: azoospermia after centrifugation, immotile testicular sperm

Case2: sperm concentration of 4.8 × 106/mL, < 5% viable in eosin test, total immotile

Case1: TESE, HOS test and ICSI

Case2: TESE, eosin test (95% viability in testicular sperm), ICSI

Case 1: Birth of a singleton after frozen embryo transfer

Case2: 4 embryos transferred with no pregnancy

Westlander et al. [15]

Case 1: severe oligozoospermia with total immotility

Case2: normal sperm count and morphology with total immotility (63% viability with HOS test, absence of dynein arms by TEM.)

Case 1. 1st attempt: HOS test and ICSI

Case1. 2nd attempt: TESE, HOS test and ICSI

Case2: Fertilized by ICSI after HOS test with half sperm injected from ejaculate and other half from TESE

Case1. 1st attempt: No fertilization

Case1. 2nd attempt: Live birth of twins

Case2: Ongoing singleton pregnancy from one embryo transfer derived from testicular sperm

Aktan et al. [23]

Cases with total immotility

HOS test or tail laser shot before ICSI

Take home baby rate/cycle of 19% vs 5.9% when testicular sperm, and 28% vs 16.7% when ejaculated sperm by laser vs random selection, respectively

Kaushal et al. [16]

sperm concentration of 58 × 106/mL, no motility, and 7% normal morphology

ICSI of partially motile sperm after TESE

Live birth of twins

Kordus et al. [37]

Total immotile sperm, 40% viability by eosin-nigrosin test, defects on dynein arms by TEM

ICSI following HOS test

Live birth of twins

Matsumoto et al. [7]

sperm concentration of 57.2 × 106/mL, 30% viability by eosin test, 0.3% sperm motility

Absence of both dynein arms by TEM, fertilization by ICSI after swim-up

Live birth of a singleton baby

Nunez et al. [47]

sperm concentration of 1.2 × 106/mL, 30% viability by eosin test, 0.3% sperm motility

HOS test to select ejaculated sperm for ICSI in 3 cycles, testicular sperm in 1 cycle using ICSI

Low grade or no cleavage embryo development, no pregnancy.

Live birth after usage of donor sperm

Hattori et al. [11]

sperm concentration of 0.9 × 106/mL, 54% viability by eosin test, no sperm motility

Absence of one or both dynein arms by TEM, pentoxifylline-activated sperm pick by ICSI

Live birth of a singleton baby

Vicdan et al. [48]

Azoospermia

Absence of dynein arms in nasal biopsy by TEM, fertilization by testicular sperm in ICSI

Live birth of a singleton baby

Geber et al. [36]

sperm concentration of 43 × 106/mL, no sperm motility

HOS test to select viable ejaculated sperm during ICSI

Live birth of twins

McLachlan et al. [12]

sperm concentration of 10.1 × 106/mL, 20% vitality, no sperm motility

Disorganized axoneme in TEM, Random testicular sperm retrieval during ICSI, assisted oocyte activation by calcium chloride rich medium

Live birth of a singleton baby

Ebner et al. [13]

sperm concentration of 1.8 × 106/mL, 32% vitality, no sperm motility

Theophylline activation resulted in no motility, HOS test selected sperm used during ICSI, assisted oocyte activation by ionophore solution

Live birth of twins

Montjean et al. [10]

2 cases with immotile spermatozoa

Case1: non-progressive motility achieved after pentoxifylline activation in first cycle, HOS test used after no pentoxifylline activated sperm in second cycle, HOS test used in third cycle

Case2: fertilization using sperm after HOS test in two cycles

Case1: No pregnancy in first two cycles, no fertilization in third cycle.

Case2: Fertilization but no pregnancy in first cycle, live birth of a singleton after second cycle using vitrified oocytes remained from first cycle