Past Issue

Volume 10, Number 2, Jul-Sep 2016, Pages: 154-161

Bone in The Endometrium: A Review


Sana N Khan, M.D, 1, Monica Modi, M.D, 2, Luis R Hoyos, M.D, 2, Anthony N Imudia, M.D, 3, Awoniyi O Awonuga, M.D, 1, *,
Department of Obstetrics and Gynecology, Section of Reproductive Endocrinology and Infertility, Wayne State University School of Medicine, Detroit, USA
Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, USA
Department of Obstetrics and Gynecology, Section of Reproductive Endocrinology and Infertility, University of South Florida, Tampa, USA
*Corresponding Address: Department of Obstetrics and Gynecology Section of Reproductive Endocrinology and Infertility Wayne State University School of Medicine 275 E. Hancock Detroit MI 48201 USA Email:aawonuga@med.wayne.edu

Abstract

To provide a comprehensive review of the published literature of patients with endo- metrial bone or osseous fragments with a view to critically examine the antecedent clinical presentation, investigations and prognosis after treatment. This systematic review of the literature includes full text articles of published case re- ports and cases series from the following computerized databases: PubMed, Ovid, and Medline between 1928 and 2013. We reviewed a total of 293 patients in 155 case reports and case series. The mean ± SD age at presentation was 32.7 ± 8.9. Approximately 88% of patients had at least one prior surgical uterine evacuation relating to pregnancy termina- tion or loss at a median gestational age of 14 weeks (range of 4-41 weeks). The most common presenting symptom was infertility (56.2%). One hundred twenty- four (66.0%) of the 188 patients attempting pregnancy after treatment achieved pregnancy prior to article publication and the majority (82.3%) were spontane- ous. Spontaneous miscarriage rate remains high (43%); however, most pregnancies ended in live-birth (55%). Bone fragments in the endometrium are most commonly found after pregnancy termina- tion, present with infertility and/or irregular menses, and upon removal, patients rapidly conceive spontaneously.