title: Bone in The Endometrium: A Review.
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.
authors.affiliation: Department of Obstetrics and Gynecology, Section of Reproductive Endocrinology and Infertility, Wayne State University School of Medicine, Detroit, USA.
authors.forename: Sana N
authors.initials: SN
authors.lastname: Khan
authors.affiliation: Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Modi
authors.affiliation: Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, USA.
authors.forename: Luis R
authors.initials: LR
authors.lastname: Hoyos
authors.affiliation: Department of Obstetrics and Gynecology, Section of Reproductive Endocrinology and Infertility, University of South Florida, Tampa, USA.
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Imudia
authors.affiliation: Department of Obstetrics and Gynecology, Section of Reproductive Endocrinology and Infertility, Wayne State University School of Medicine, Detroit, USA.
authors.forename: Awoniyi O
authors.initials: AO
authors.lastname: Awonuga
keywords: Female; Infertility; Metaplasia; Ossification; Surgery