Casper et al. (1996) also showed that the HOST can be used successfully to select viable spermatozoa and increase the fertilization rate nearly twofold over random selection (Casper et al., 1996). In summary, we report a successful fertilization outcome via ICSI with HOST activated sperm from a patient carrying two novel CCDC40 mutations from a Chinese PCD family, we also found diverse ultrastructural defects in cilia of the different patients carrying the same mutations, which were not reported previously in PCD patients. Here, DNAH5 is linked to primary ciliary dyskinesia.