Successful pregnancy with donor eggs in-vitro fertilization after premature ovarian insufficiency in a tertiary hospital in a low-income setting: a case report

Abstract

BackgroundPremature Ovarian Insufficiency (POI) is classically defined as 4–6 months of cessation of menses (amenorrhea) in women under 40, associated with menopausal level of serum gonadotropins FSH > 40 IU/L and hypo-estrogenism and is also referred to as hypergonadotropic hypogonadism. This disorder can manifest as primary amenorrhea without the onset of menses (menarche), or as secondary amenorrhea after menarche and pubertal development. The diagnosis of this condition in Cameroon is sometimes difficult because of the high cost of hormonal assays and the few laboratories offering these services.Case presentationThe patient was a 38-year-old G2P0020, blood group O Rh positive, genotype AA and BMI 19 kg/m2 who came to our service because of secondary amenorrhea and infertility of 2 years’ duration. She has a history of pulmonary tuberculosis that was treated in Cameroon. After laparoscopy and hormonal profile, the diagnosis of premature ovarian insufficiency was reached. The woman underwent a successful donor egg in-vitro fertilization cycle and delivered a female fetus. Two years later YE requested IVF with autologous eggs, which was not possible, and since then she has remained with one child.ConclusionThe diagnosis of premature ovarian insufficiency is difficult in Cameroon because of the high cost of laboratory investigations and difficult access to the tests. In-vitro fertilization with donor egg is a better treatment option. Unfortunately, it is not accessible to most Cameroonians because of lack of technical ability and the existence of cultural and financial barriers.

Infertility and associated factors in three hospitals in Douala, Cameroon: a cross-sectional study

“…This is related to lack of technical know how in some health facilities or lack of finances on the part of the couples. This is compounded by the fact that health insurance does not cover infertility matters for the small proportion of workers who have health insurance as compared to high-income countries such as Israel, France and Belgium 36 , 37 . For this reason, medical practitioners are sometimes obliged to use the syndromic approach to diseases (based on association of symptoms and signs) in the management of many medical conditions including infertility in Cameroon 38 .…”

A case of Mayer-Rokitansky-Küster-Hauser syndrome in a low-resource tertiary hospital in Douala, Cameroon

“…These procedures are usually too costly for Cameroonian couples; besides, most cultures reject IVF babies as abnormal. 8 The prevalence of MRKH syndrome has been reported to be 1 in 5000 live female births in Caucasians. 1 Furthermore, the etiology of MRKH syndrome remains unknown; however, reports on familial clustering of MRKH syndrome and its associated anomalies suggest a genetic component.…”

“…7 That notwithstanding, these new approaches are still not accessible to many couples in Cameroon and most low-income countries. 8 We are presenting the case of MRKH syndrome that was managed at the Department of Obstetrics and Gynecology in a low-resource tertiary hospital in Douala, Cameroon.…”

Pyosalpinges after hysterosalpingography in a patient with lower genital tract infection and managed by laparoscopic surgery in a resource low tertiary hospital case report and literature review

“…However, in most healthcare facilities in Cameroon, laparotomy is the mainstay of treatment for lack of expertise and equipment to practice laparoscopic surgery. Furthermore, the patient was also counseled to undergo In-vitro fertilization after laparoscopy [ 39 ]. Being young 29 years old might give a good yield of ovarian follicles for IVF and it has been reported previously that salpingectomy for hydrosalpinges improves IVF results [ 40 , 41 ].…”

“…Being young 29 years old might give a good yield of ovarian follicles for IVF and it has been reported previously that salpingectomy for hydrosalpinges improves IVF results [ 40 , 41 ]. In Cameroon, IVF-ET is practiced in three centres; two private sector centres in Douala and one public IVF centre in Yaounde as reported previously [ 39 ]. The only difficulty she may face may be her family’s inability to handle the cost.…”