Infertility Due to Prolonged Retention of Fetal Bones: A Case Series

Background: Prolonged retention of fetal bones is often overlooked as a possible cause of infertility due to their rarity. The condition is more likely to occur in countries with restrictive abortion laws, where pregnancy termination for social reasons often occurs in midtrimester and clandestine situations. This article presents cases of retained fetal bones in 4 Nigerian women. Cases: Transvaginal ultrasonography (TVUS) was performed for women undergoing evaluation for infertility at the Obafemi Awolowo University Teaching Hospitals Complex, in Ile-Ife, Nigeria, between July 2019 and October 2020. The patients' TVUS results were compared with their hysterosalpingography (HSG) results. Results: Four cases of prolonged retention of fetal bones were diagnosed among 141 women who underwent TVUS. Each of the 4 women had a history of midtrimester surgical termination of pregnancy. The fetal bones were not recognized on HSG. After TVUS results showed that fetal bones were present, hysteroscopic retrieval of multiple white, hard, and gritty masses was undertaken in all of these women. The masses were all histologically confirmed to be fetal bones, Two patients without any comorbidity conceived spontaneously with live births, while the other 2 diagnosis of prolonged women proceeded to in vitro fertilization due to bilateral tubal blockages. Conclusions: TVUS aids the diagnosis of prolonged retention of fetal bones, even when they are initially missed on HSG, and hysteroscopic retrieval leads to rapid return of fertility. (J GYNECOL SURG 38:107)