Secondary infertility due to intrauterine fetal bone retention: A case report and review of the literature

• Main Authors: Atossa Mahdavi, Sasan Kazemian, Emad Koohestani
• Format: Article
• Language: English
• Published: Shahid Sadoughi University of Medical Sciences 2019-08-01
• Series: International Journal of Reproductive BioMedicine
• Subjects: bone; infertility; hysteroscopy; pregnancy; abortion
• Online Access: https://doi.org/10.18502/ijrm.v17i8.4825

Background Intrauterine retention of fetal bone fragments is a rare condition that could happen after abortion (especially illegal abortion). It can cause secondary infertility as bone fragments can work as an intrauterine contraceptive device. Case A 25-year-old Iranian woman was referred to Shariati Hospital due to infertility. During infertility work up to normal semen analysis, adequate ovarian reserve with regular ovulatory cycles was documented. An ultrasound scan revealed focal echogenic shadowing lesions inside the uterine cavity. Hysteroscopy was conducted and many intrauterine bone fragments were revealed. Six months after hysteroscopic removal of fetal bones, the patient became pregnant and delivered a healthy and term baby. Conclusion Intrauterine fetal bone retention is a scarce event that happens after pregnancy termination due to the incomplete evacuation of fetal tissues. It can cause dysfunctional uterine bleeding, menorrhagia, dysmenorrhea, pelvic pain, abnormal vaginal discharge, and secondary infertility. The detection of the problem and the removal of the remained bones by hysteroscopy have made possible to treat the patient safely and restore normal uterine function and female fertility.