Fertilité après résection élective hystéroscopique de lésions de métaplasie ostéoïde de l’endomètre

H. Creux, Jean‐Noël Hugues, Christophe Sifer, Isabelle Cédrin‐Durnerin, C. Poncelet
In: Gynécologie Obstétrique & Fertilité · 2010 · vol. 38(7-8) , pp. 460–464 · doi:10.1016/j.gyobfe.2010.05.006 · PMID:20579919 · W2046956325
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This paper investigates fertility outcomes following hysteroscopic resection of osteoid metaplasia of the endometrium.

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Abstract

ObjectivesThe endometrial osseous metaplasia is a rare disease which is characterized by the presence of osseous tissue in endometrium. It is often diagnosed in women with secondary infertility. The main objective of this work is to evaluate fertility after elective resection of osteoid metaplasia endometrial lesions by operative hysteroscopy in infertile women.Patients and methodRetrospective and descriptive series of 7 cases observed in the Woman and Child department, CHU Jean-Verdier. The 7 women were in reproductive age, of African origin, with secondary infertility after abortions concerning 6 out of the 7 patients.ResultsIn all cases, endovaginal pelvic ultrasound has raised endometrial calcification, and diagnostic hysteroscopy highlighted endometrial osteoid metaplasia. The operative hysteroscopic procedure consisted of elective diathermic resection to handle endometrial insertion of bone chips. A second diagnostic hysteroscopy was systematically done. It showed no recurrence. Six of the 7 patients began pregnancy, 3 spontaneously and 3 after IVF/ICSI in the first year following the hysteroscopic treatment. The evolution of pregnancies has been marked by 2 normal deliveries, 1 spontaneous miscarriage and then an ectopic pregnancy in one patient, 1 growth retardation intrauterine requiring caesarean at 38 SA, 1 HELLP syndrome in a twin pregnancy requiring ceasarean at 27 SA followed normal labor at term and 1 pregnancy lost sight.Discussion and conclusionHysteroscopic elective resection seems to be the treatment of choice with a good prognosis on subsequent fertility.

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