Intrauterine retained fetal bones as a cause of secondary infertility

Abstract

Three cases of retained fetal bones, the first two after mid-trimester termination of pregnancy and the third after dilatation and evacuation (D&E) of the uterus for a missed abortion, are presented. All the cases were complicated by secondary infertil-ity. In all the cases the diagnosis was confirmed by a high resolution pelvic ultrasound scan. The pieces of bones were removed at dilatation and evacuation under general anaesthesia. In two of the cases pregnancy occurred within 6 months of re-moval of the bones. It is believed that bones re-tained freely in the endometrial cavity behave as an intrauterine contraceptive device (IUCD). Be-cause of the many complications associated with mid-trimester dilatation and evacuation of the uterus, its role in modern gynaecology should be limited. It is suggested that retained fetal bones should be considered in the differential diagnosis of women presenting to infertility clinics when there is a history of mid-trimester D&E of the uterus.