A case of permanent endometrial hypotrophy after long-term use of oral contraceptives

We report the case of a 32-year-old patient who after 14 years of uninterrupted use of low-dose, combined, oral contraceptive agents presented permanent endometrium damage. The patient was referred for prolonged unexplained infertility with medical history negative for any kind of endometrial trauma or subclinical endometritis. After the suspension of the oral contraceptives the patient showed a particular discrepancy between a prompt recovery of the menstrual cycle and absolute inability to obtain a normal endometrial growth. The poor endometrial response appeared during cycles of ovarian stimulation as well as during cycles of hormone replacement. A review of the literature and theoretical interpretations have been attempted in the discussion.