Endometrial osseous metaplasia: an evolving cause of secondary infertility

In: Fertility and Sterility · 2008 · vol. 90(5) , pp. 2013.e9–2013.e11 · doi:10.1016/j.fertnstert.2008.01.001 · PMID:18325514 · W2058418981
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Endometrial osseous metaplasia, a condition where bone forms in the uterine lining, is an increasingly recognized factor contributing to secondary infertility.

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Abstract

ObjectiveTo present an endometrial osseous metaplasia case and reemphasize that the condition is a cause of secondary infertility.DesignCase report.SettingDepartment of Obstetrics and Gynecology in a university hospital in Turkey.Patient(s)A 33-year-old multiparous woman was admitted to our institution with secondary infertility that had lasted for 2 years. She had experienced one first-trimester and one second-trimester abortion, 3 years and 2 years ago, respectively. On transvaginal sonography, a linear curvy echogenity was observed.Intervention(s)Hysteroscopic examination revealed multiple bony spicules, extending perpendicularly from the posterior uterine wall in to the uterine cavity and occupying almost two thirds of the cavity. Thereafter, a resectoscopic excision of the bony spicules was performed.Main outcome measure(s)A normal endometrium and uterine cavity.Result(s)Two weeks after the operation, ultrasonographic evaluation was in the normal range, and the patient currently is trying to conceive spontaneously.Conclusion(s)Although the role of office hysteroscopy in the evaluation of infertile couple is still under debate, clinicians should keep this rare disorder in mind, especially in patients with a history of late abortion, and should evaluate such cases by hysteroscopy when sonographic features are encountered.

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