Osseous metaplasia of endometrium: a rare cause of secondary infertility

Abstract

Osseous metaplasia of the endometrium is a rare condition with formation of bony tissue inside the uterus, particularly the endometrium. The etiology of this disorder is not completely understood, with various hypotheses being put forward to explain its occurrence. It is an important cause of secondary infertility, although it may present with various other gynecological symptoms. It can be suspected on ultrasonography due to its peculiar appearance and can be completely cured following hysteroscopic resection. Here we present a case of a 30 years old female presenting with hypomenorrhoea and secondary infertility following a first trimester abortion. Ultrasonography showed presence of dense linear echogenic band in the uterus suggestive of calcification. Hysteroscopy revealed multiple bony fragments of varying shapes and sizes (0.2-2cm) in the uterine cavity which were removed using a hysteroscopic grasper and the cavity was restored to normal. There were no procedure related complications. Presence of bony tissue was confirmed on histopathology. Patient had a spontaneous conception 3 months after the procedure and delivered a healthy male child at term. Thus, in our case, hysteroscopy was a safe and effective modality for diagnosis as well as treatment of this rare condition. Successful hysteroscopic treatment was followed by a spontaneous conception and a good pregnancy outcome.