Hysteroscopic management of osseous endometrial metaplasia causing secondary infertility
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20240484Keywords:
Endometrial metaplasia, Hysteroscopic excision, Osseous metaplasia, Secondary infertilityAbstract
Osseous endometrial metaplasia is a rare pathological condition frequently associated with infertility. Despite multiple theories about its development, the exact mechanism, the source of the osseous tissue and the possible treatment outcomes are not clearly defined. Moreover, it is yet not clear whether surgical removal of the osseous tissue can restore fertility in the patients. We present three patients who presented to us with secondary infertility and were diagnosed to have osseous endometrial metaplasia. They were then treated with hysteroscopic removal of the osseous fragments. All three patients had spontaneous conception after the procedure. Hysteroscopic removal of bony spicules can provide reasonable chances of spontaneous conception in such patients provided the metaplasia does not extend deep into the myometrium.
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References
Singh P, Kapur K, Singla S, Naz N. Endometrial osseous metaplasia and mature bone formation with extramedullary hematopoiesis. J Hum Reprod Sci. 2011;4:56‐7.
Adamson NE, Sommers SC. Endometrial ossification: report of two cases. Am J Obstet Gynecol. 1954;67: 187-90.
Bhatia NN, Hoshiko MG. Uterine osseous metaplasia. Obstet Gynecol. 1982;60:256-9.
Shroff CP, Kudterkar NG, Badhwar VR. Endometrial ossification-- report of three cases with literature review. Indian J Pathol Microbiol. 1985;28:71-4.
Van den Bosch T, Dubin M, Cornelis A. Favourable pregnancy outcome in a woman with osseous metaplasia of the uterus. Ultrasound Obstet Gynecol. 2000;15:445-7.
Torné A, Jou P, Pagano R, Sanchez I, Ordi J, Vanrell JA. Endometrial ossification successfully treated by hystero- scopic resection. Eur J Obstet Gynecol Reprod Biol. 1996;66:75-7.
Lainas T, Zorzovilis I, Petsas G, Alexopoulou E, Lainas G, Ioakimidis T. Osseous metaplasia: case report and review. Fertil Steril. 2004;82:1433-5.
Silverberg SG, Tabbara SO. The uterine corpus. In: Silverberg SG, eds. Principles and practices of surgical pathology and cytopathology. 3rd ed. USA: Churchill livingstone; 2001:2470‐2.
Bahçeci M, Demirel LC. Osseous metaplasia of the endometrium: a rare cause of infertility and its hysteroscopic management. Hum Reprod. 1996;11: 2537-9.
Shroff CP, Kudterkar NG, Badhwar VR. Endometrial ossification-- report of three cases with literature review. Indian J Pathol Microbiol. 1985;28:71-4.
Shimizu M, Nakayama M. Endometrial ossification in a postmenopausal woman. J Clin Pathol. 1997;50:171-2.
Torné A, Jou P, Pagano R, Sanchez I, Ordi J, Vanrell JA. En- dometrial ossification successfully treated by hysteroscopic resection. Eur J Obstet Gynecol Reprod Biol. 1996;66:75-7.
Onderoglu LS, Yarali H, Gultekin M, Katlan D. Endometrial os- seous metaplasia: an evolving cause of secondary infertility. Fertil Steril. 2008;90:9-11.
Tulandi T, Al-Sunaidi M, Arseneau J, Tonin PN, Arcand SL. Calcified tissue of fetal origin in utero. Fertil Steril. 2008;89:217-8.
Cayuela E, Perez-Medina T, Vilanova J, Alejo M, Cañadas P. True osseous metaplasia of the endometrium: the bone is not from a fetus. Fertil Steril. 2009;91:1-4.
Lainas T, Zorzovilis I, Petsas G, Alexopoulou E, Lainas G, Ioakimidis T. Osseous metaplasia: case report and review. Fertil Steril. 2004;82:1433-5.
Coccia ME, Becattini C, Bracco GL, Scarselli G. Ultrasound-guided hysteroscopic management of endometrial osseous metaplasia. Ultrasound Obstet Gynecol. 1996;8:134-6.
Rosa-E-Silva JC, Barcelos ID, Navarro PA, Rosa-E-Silva AC, Nogueira AA, Ferriani RA. Osseous metaplasia of the endometrium associated with infertility: a case report and review of the literature. J Med Case Rep. 2009;3:7427.
