“When healing becomes hindrance”: subfertility due to endometrial osseous metaplasia hysteroscopic treatment and subsequent outcome: a case report and review of the literature

Endometrial osseous metaplasia is a rare clinical entity that can present in varied ways. Patients may present with abnormal uterine bleeding or subfertilty in majority of the cases. It usually results from prior endometritis with subsequent osseous metaplasia during healing. Its management involves hysteroscopic removal with good outcomes reported in literature. We present a case of endometrial osseous metaplasia resulting to subfertility with its management and subsequent outcome. A 38-year-old black Kenyan lady presented with an 8-year history of subfertility. She had no significant symptoms in her history with a regular and painless menstrual cycle. Her ultrasound revealed a linear calcification within the endometrial cavity that measured approximately 2 cm. The ovaries and adnexa appeared normal. Hysteroscopic excision was done as a day case with no complications. She subsequently conceived spontaneously in the next cycle and went on to deliver a term infant via caeserean delivery due to obstetric indications. EOM is a rare clinical entity and can cause subfertility as presented in the case. It usually is a result of prior endometritis with subsequent osseous metaplasia. Hysteroscopy is the gold standard of diagnosis and treatment. Most patients have an excellent prognosis as described in the case.