Hysteroscopic management of osseous endometrial metaplasia causing secondary infertility

Osseous endometrial metaplasia is a rare pathological condition frequently associated with infertility. Despite multiple theories about its development, the exact mechanism, the source of the osseous tissue and the possible treatment outcomes are not clearly defined. Moreover, it is yet not clear whether surgical removal of the osseous tissue can restore fertility in the patients. We present three patients who presented to us with secondary infertility and were diagnosed to have osseous endometrial metaplasia. They were then treated with hysteroscopic removal of the osseous fragments. All three patients had spontaneous conception after the procedure. Hysteroscopic removal of bony spicules can provide reasonable chances of spontaneous conception in such patients provided the metaplasia does not extend deep into the myometrium.