Osseous Metaplasia of Endometrium: The Bony Womb and Its Hysteroscopic Management

Abstract

Background: Endometrial ossification is an uncommon disease related to secondary infertility with controversial etiopathogenesis. More than 80% of reported cases occur after pregnancy. Case: A 29-year-old woman presented to us with history of primary infertility and hypomenorrhea. Her pelvic ultrasound showed multiple intrauterine hyperechogenic contents suggesting calcifications. Office hysteroscopy revealed multiple coral-like white plaques involving the anterior and posterior walls of the uterus. Hysteroscopic resection was done uneventfully followed by antiadhesion measures. Microscopic examination showed endometrial tissue with osseous metaplasia in the stroma. Patient was empirically given antitubercular therapy (ATT) and conceived 3 months after completion of therapy spontaneously. Result: After surgical normalization of endometrial cavity and completion of ATT, the patient conceived spontaneously. Conclusion: In our patient, hysteroscopy was effective in the diagnosis and treatment of osseous metaplasia of the endometrium associated with infertility.