Background: Polycystic ovary syndrome (PCOS) is a heterogeneous syndrome posing diagnostic problems in current practice, because of the cumbersomeness associated with the application of the criteria that define it; giving rise to over or under diagnosis of it. Anti-Müllerian hormone (AMH) is an effective alternative in this case, being a stable, reproducible and non-operator dependent marker to diagnose PCOS due to the link that binds it to the multiple pre-antral follicles in the ovaries of PCOS patients. The aim of this study was to determine the threshold value of AMH required to define PCOS in our African population, by revealing the correlation with antral follicles count (AFC) on endovaginal ultrasound.Methods: We carried out a comparative cross-sectional study, with retrospective data collection in 23 infertile patients diagnosed with PCOS according to the Rotterdam 2003 criteria, and 23 non-PCOS infertile controls having performed the AMH test using the Immunotech technique at CHRACERH. Endovaginal ultrasound (U/S) was performed using a 7.5 mega Hertz (MHz) transvaginal transducer by different qualified operators (radiologists, gynecologists). The comparison of the two independent groups (PCOS and non-PCOS) was performed by the Student t-test; correlations between AMH, age, AFC and ovarian volume obtained by the Pearson test; and the diagnostic power of AMH test in PCOS was evaluated by receiver operating characteristic curves (ROC).Results: AMH was approximately twice as high in PCOS compared to controls (6.09 versus 3.80, P <0.001) and was inversely correlated with age (r = -0.301; P ˂0.05); significantly correlated antral follicle count (R = 0.85, P <0.0001) and ovarian volume (r = 0.625, P <0.0001). ROC analysis revealed that the AMH test was very informative for the diagnosis of PCOS with an area under the curve (AUC) at 0.90 (0.81-0.99; 95% CI); and the threshold value given by the farthest point of the diagonal representing the nil contribution test was 4.40 ng/L, and predicted PCOS with a sensitivity of 96% and a specificity of 70%.Conclusions: AMH is a predictive marker for PCOS. It is highly correlated with AFC and ovarian volume and appears to decrease with age. It offers good diagnostic performance in PCOS, with a threshold value of 4.40 ng/L for a sensitivity of 96% and specificity of 70%.

Background: With the advent of Assisted Reproduction Technology, management of infertility amongst couples has remarkably evolved. Despite this great leap, with an increase in the rate of fertilization, few pregnancies progress until birth. The objective of this study was to compare the evolution of pregnancies obtained after IVF to those obtained naturally. Methodology:We carried out a descriptive cross-sectional study with retrospective and prospective data collection from August 1 st , 2016 to April 30, 2019. Our study had two groups of pregnant women, the spontaneous pregnancy group and the post-IVF pregnancy group. Sampling was consecutive and exhaustive. Sociodemographic, clinical and para-clinical variables were collected. The Chi-square and Fischer's exact tests were used to compare variables. The odds ratio was calculated to determine associations between variables. A p value of < 0.05 was considered significant.Results: A total of 350 pregnancies were included in the study which comprised of 250 spontaneous pregnancies and 100 pregnancies obtained after IVF. Women pregnant through IVF, had an increase in the probability of being; nulliparous (OR: 26.18;]; p=0.01), primiparous (OR: 1.8; CI [1.12-2.88]; p<0.01), having multiple pregnancies (OR: 4.95;]; p<0.01) and first trimester vaginal bleeding (OR: 16.72;]; p<0.01) as compared to spontaneous pregnancies. We also observed that IVF pregnancies were 3.31 times more likely to end in elective cesarean section at the time of delivery than spontaneous pregnancies (OR: 3.31;]; p<0.01). Some of the obstetric and neonatal complications we studied had a comparable risk between the two groups without statistical significance. Conclusion:IVF pregnancies have a higher risk of bleeding and miscarriage in the first trimester with a higher probability in resulting to an elective cesarean section at the time of delivery compared to spontaneous pregnancies.

This suggestion only takes into account the past surgical history, but not anatomical features of the fistula (location, size, fibrosis). 16-18 Some studies reported prognostic value of urethral location and the fistula increased failure risk in case their involvement. 19,20 Success of 57% was reported for cervico-urethral location and 79% for bladder body involvement. 21 Little data exists on the prognosis of obstetric fistula with urethral involvement in Cameroon. Objective: Analyze post-surgical outcome of genitourinary obstetric fistula with or without urethral involvement. Methodology This was a retrospective cohort study in the University Teaching Hospital, Yaounde on GUOF patients operated from 03 March 2009 to 3 March 2015 (six years). We considered obstetric fistula with urethral involvement "subject group" and obstetric fistula without urethral involvement "control group". Patient's files were reviewed, we excluded non-obstetric, genitourinary digestive and vesico-uterine cases. After an oral consent, we collected data through registers,

Nous rapportons les résultats d'une série de 21 cas de prise en charge par cryothérapie de lésions intra-épithéliales cervicales au Centre Hospitalier et Universitaire (CHU) de Yaoundé. Notre objectif principal était d’évaluer les résultats préliminaires de la prise en charge des lésions précancéreuses éligibles pour la cryothérapie. Il s'agissait d'une étude transversale descriptive qui s'est étalée sur 24 mois. Etaient inclus dans l’étude toutes les femmes traitées par cryothérapie. Nous avons exclu les patientes traitées par une autre méthode, les patientes perdues de vue et les dossiers incomplets. Le statut cervical a été déterminé à 6 semaines, 6 mois et 12 mois. Les complications précoces et tardives ont également été répertoriées. Au total 95.2% des lésions étaient cicatrisées à 6 semaines. A 6 mois, toutes les lésions avaient disparu et au 12ème mois, la guérison était effective chez 95.2% des patientes. Les saignements et l'hydrorrhée étaient les principales complications tardives avec des fréquences respectives de 66.7% et 95.2%. Aucun cas de sténose cervicale n'a été répertorié. La cryothérapie peut être utilisée comme méthode de traitement pour des lésions précancéreuses du col.

Background: Uterine cavity abnormalities are seen as a cause of infertility in around 10%-15% and can go up to 50% in women with recurrent implantation failure. Saline infusion sonohysterography (SIS) is a minimally invasive diagnostic modality in the evaluation but hysteroscopy remains the gold standard in the assessment of intra uterine cavity. The aim of this study was to compare the diagnostic accuracy of saline infusion sonography (SIS) considering hysteroscopy (HS) as the gold standard to evaluate uterine cavity pathologies in infertile women at CHRACERH. Methods: Authors carried out a cross-sectional, retrospective study, over 2 years, from the 1st January 2016 to the 31st December 2017, with retrospective data collection in 110 records of infertile patients subjected to an ultrasound assessment of uterine cavity using saline as the contrast medium with a 6.5-MHz transvaginal transducer. When SIS found intra uterine abnormality, HS was done on a later date, using a 5 mm Bettocchi hysteroscope. Sensitivity, specificity, accuracy, positive and negative predictive values of SIS and HS were compared using the SPSS 20 software. Results: The mean age and body mass index were respectively 39.3±7.8 years and 28.7±4.1 kg/m². The main findings both in SIS and Hysteroscopy were respectively polyps (n=61; 55.5% vs 52.7%; n=58), myomas (n=43; 39.1% vs 31.8%; n=35), intrauterine adhesions (n=18; 16.4% vs 21.8%; n=24). The overall sensitivity, specificity and accuracy of SIS were 81.2%, 86.9% and 86.5% respectively. Conclusions: SIS as a diagnostic tool in the evaluation of intrauterine lesions has a good accuracy and can therefore replace HS when this later is not available, especially in our African setting.