Secondary infertility caused by the retention of fetal bones after an abortion: a case report

Hannah Mc Kramer,Johann Pt Rhemrev

doi:10.1186/1752-1947-2-208

Hannah Mc Kramer, Johann Pt Rhemrev

Open Access

https://doi.org/10.1186/1752-1947-2-208

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Abstract

IntroductionUnwanted contraception through prolonged retention of fetal bone is a rare cause of secondary infertility. It is usually associated with a history of abortion, either spontaneous or induced.Case presentationWe describe a case of intrauterine retention of fetal bone diagnosed 8 years after the termination of a pregnancy. The patient had no complaints of pain, irregular vaginal bleeding or discharge. A hysteroscopy was performed and irregular structures were removed. These fragments were fetal bones, which probably functioned as an intrauterine contraceptive device. After removal of the fetal bone fragments the patient conceived spontaneously within 6 months.ConclusionThis case report stresses the importance of taking a thorough history and evaluation of the endometrium by transvaginal ultrasound or hysteroscopy in women with secondary infertility.

Highlights

Unwanted contraception through prolonged retention of fetal bone is a rare cause of secondary infertility
This case report stresses the importance of taking a thorough history and evaluation of the endometrium by transvaginal ultrasound or hysteroscopy in women with secondary infertility
We describe a rare cause of secondary infertility due to prolonged retention of intrauterine bone after a dilatation and curettage

Summary

Introduction

90% of these abortions were performed on patients between 15 and 34 years of age [1]. Since 50% of abortions are performed on young patients, these women may develop future fertility problems caused by previous procedures. A number of case reports have been published on the prolonged retention of fetal bones up to 23 years after an abortion, either spontaneous or induced [3]. Thereafter, three in vitro fertilization (IVF) cycles were performed in which qualitative perfect blastocysts were transferred without conception. The cause of this problem was thought to be malfunctioning endometrium. A second hysteroscopy showed a normal empty uterine cavity with a normal endometrial lining.

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Conclusion