Chronic cough and infertility: a report of two cases

Abstract 

Objective: To report two cases of infertility caused by primary ciliary dyskinesia in patients who presented with an associated complaint of a chronic cough.

Design: Case report.

Setting: University teaching hospital.

Patient(s): Two patients presenting with unexplained infertility and an associated history of long-term chronic cough.

Intervention(s): Patients underwent a nasal mucosal biopsy by an otolaryngologist. Electron microscopy (EM) examination of biopsy specimens was performed.

Main Outcome Measure(s): Diagnosis and appropriate treatment for functional tubal factor infertility.

Result(s): Both patients were diagnosed with primary ciliary dyskinesia based on EM of the nasal biopsy specimens. Given this diagnosis, they immediately underwent IVF-ET. Both patients became pregnant with their first IVF-ET cycle.

Conclusion(s): Other investigators have shown that almost 20% of patients with a chronic cough will have EM evidence of ciliary dyskinesia. Patients presenting with idiopathic infertility and an associated unexplained chronic cough should be referred for nasal biopsy with EM evaluation to rule out primary ciliary dyskinesia. Infertility in these cases, which is due to a functional tubal factor, is best treated with IVF-ET rather than superovulation and intrauterine insemination treatments.

Keywords:  Ciliary dyskinesia, ciliary dysfunction, immotile cilia syndrome, Kartagener’s syndrome, dynein arms, infertility