Practice of ovarian stimulation among poor responders in a country with limited resources: case of the Paul and Chantal Biya human reproduction center, Yaoundé, Cameroon

Background: Approximatively 2 to 30% of women who undergo ovarian stimulation have a poor response. The management is not clearly defined, constituting a challenge for clinicians and biologist. Methods: This was a longitudinal descriptive study with prospective data collection that took place at Paul and Chantal Biya Gynecological Endoscopic surgery and Human Reproductive Teaching Center, during a period of 1 year and 6 months, from June 2020 to November 2021. Our objective was to describe the practice of ovarian stimulation of patients judged to be poor responders in CHRACERH. We highlighted the numbers, percentages, averages and their standard deviations. Statistical analyzes were carried out using SPSS v15.0 software. Results: Out of 159 cycles included, we identified 55 patients considered possible poor responders, i.e. a prevalence of 34.6%; the average age was 36.36±6.2 years with extremes ranging from 33 to 44 years, mainly overweight in 81.8% of cases. The average AMH level was 0.9±0.4 ng/ml, the average CFA 6.15±3.7. 87.3% of patients were on their first stimulation attempt, the long-delay agonist protocol and the short agonist protocol were used in 58.2% and 41.8% respectively. The maximum daily dose in patients was 300 IU with an average total dose of gonadotropin used of 3371.8±874 IU. At the end of the ovarian stimulation, the average number of follicles collected and mature oocytes were respectively 5.6±3.6 and 4±2.9 with an average maturity rate of 70.7±31% as well as an average fertilization rate in ICSI of 45.2±32%. The pregnancy rate was 12% among poor responders. Conclusions: Poor responders constitute a large proportion of patients stimulated at CHRACERH; their still low pregnancy rates prompt an improvement in care