Care Pathways for Infertility in Cameroon: Between Traditional Practices and Medically Assisted Reproduction

Introduction: Infertility remains a major reproductive health problem in Cameroon, with a high prevalence of secondary infertility often linked to sexually transmitted infections, unsafe abortions, and pelvic surgery complications. In a context where motherhood is an essential determinant of social recognition, infertile women adopt complex therapeutic pathways combining traditional and biomedical practices. This study aimed to describe and analyze the care pathways of infertile women in Douala. Methods: A cross-sectional analytic study was conducted from January to July 2025 in four health facilities in Douala. Women aged 25 - 55 years, diagnosed with infertility and who provided informed consent, were included (n = 173). Data collected covered sociodemographic and clinical characteristics, as well as therapeutic recourse. Associations between therapeutic choices and women’s characteristics were explored using the Chi-square test. A multivariate logistic regression model was used to identify independent determinants of recourse to traditional versus biomedical practices. Statistical significance was set at p Results: The mean age was 37.2 ± 6.1 years; 76.9% had secondary infertility. A history of sexually transmitted infections and abortion was reported by 53.7% and 52.6% of participants, respectively. Therapeutic approaches were diverse: self-medication (63.6%), herbal medicine (68.2%), ovarian stimulation (51.8%), pelvic surgery (32.4%), and in vitro fertilization (8.7%). Determinants of therapeutic choices included low income (OR = 2.3 (1.2 - 4.4); p = 0.01) associated with herbal medicine, higher education favoring access to medically assisted reproduction (OR = 1.8 (1.1 - 3.1); p = 0.03), and a history of sexually transmitted infections associated with combined care pathways (OR = 2.6 (1.4 - 4.7); p = 0.004). Conclusion: Therapeutic pathways among infertile women in Douala are characterized by the predominance of self‑medication and herbal medicine, alongside a growing yet limited use of assisted reproductive technologies. Socioeconomic and educational factors strongly shape these choices. An integrated approach combining prevention, regulation of traditional practices, and improved access to modern reproductive care is essential to optimize infertility management in Cameroon.