Secondary Infertility due to Fetal Bone Retention

Abstract

Prolonged intrauterine retention of fetal bones during an abortion procedure can lead to secondary infertility A total of 17 case reports, 7 case series, and one retrospective study were included, with a total of 75 patients. 60% had a termination in the 2nd trimester, while 20% had a pregnancy termination during the 1st trimester. Hysteroscopic resection was used to remove the intrauterine fetal bones in 69% of patients. 59 % of patients could conceivefollowing the procedure, 1% conceived despite the presence of intrauterine bones, 24% could not conceive at the time of the study, and 16% of patients had an unknown outcome. Transvaginal in 41 (55%) and pelvic ultrasound in 21(28%) were used for diagnosis. Secondary infertility is a common occurrence after a D&C procedure partially due to fetal bone retention. The gold standard for an accurate diagnosis and treatment is hysteroscopy.

Hysteroscopic Management of Retained Fetal Bones In utero

“…[ 2 ] However, retained fetal bones or calcified RPOC usually presents late and has atypical presentations such as secondary infertility, irregular menstrual cycles, vaginal discharge, abnormal uterine bleeding, chronic pelvic pain, and recurrent pregnancy losses. [ 3 4 ]…”