Endometrial osseous metaplasia: an evolving cause of secondary infertility.

Objective: To present an endometrial osseous metaplasia case and reemphasize that the condition is a cause of secondary infertility.

Design: Case report.

Setting: Department 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.