Infertility and sub-fertility are common manifestations of PCD. Male infertility used to be considered universal, but there are reports of male PCD patients with normal reproductive capabilities. Females may experience sub-fertility and/or an increased risk for ectopic (tubal) pregnancy. Many women with PCD have achieved pregnancy naturally, however. For family planning purposes, it is important not to assume you will be infertile just because you have PCD!
Subfertility in PCD is a mechanical issue—a matter of being unable to get the necessary reproductive components where they need to be. This should be distinguished from ‘sterility,’ which implies that the components themselves are not viable. Because most people with PCD have sperm and egg cells that are perfectly fine, just unable to travel due to ciliary inactivity, IVF, ICSI and other assisted reproductive services have been used with a high level of success in PCD.
A person with PCD has two ‘bad’ copies of a PCD gene. Thus, they have no ‘good’ copy to pass on. All of their children will inherit one of these mutated copies, so all will be a PCD carrier. If the other parent is also a carrier (has one copy with a pathogenic PCD mutation ON THE SAME PCD GENE AS THE PCD PARENT), there is a 50/50 chance that the child will inherit the bad copy from the carrier parent. Since the PCD parent only has bad copies to contribute, the child will inherit two bad copies and have PCD. However, this is only an issue if the carrier parent’s pathogenic mutation is on the same gene as the PCD parent. The odds of this, while not impossible, tend to be very, very low given how rare PCD is. There are actually no documented incidences of this occurring to date outside of communities that practice familial intermarriage.
So all children of a PCD parent will be PCD carriers. Under certain conditions, if a PCD parent and a PCD-carrier parent have children, there is a 50/50 chance a child could be born with PCD, but this is a very rare occurrence.