IUI treatment in Pakistan

IUI is also called artificial insemination. The NHS (the UK's National Health Service) describes it as a procedure to help you get pregnant, in which sperm are put directly into your womb (uterus) when you're ovulating.

The sperm is first washed to separate the better-quality sperm. ReproductiveFacts, from the American Society for Reproductive Medicine, says placing sperm past the cervix (the narrow, lower part of the womb) makes their journey to the fallopian tubes (the tubes connecting the ovaries to the womb) much shorter. The sperm is then left to fertilise the egg naturally, inside the body.

This is a typical IUI cycle, as the NHS and the HFEA describe it; your own treatment may be slightly different.

1. Tests

   Tests check that IUI is suitable, including that the fallopian tubes are open and healthy. The male partner has tests too, such as a semen analysis (a check for sperm problems).

2. Natural cycle or medicines

   IUI can be done in your normal menstrual cycle or with fertility medicines to boost egg production. Without medicines, blood or urine tests show when you're ovulating, which the NHS says is usually 12 to 16 days before your next period is due.

3. Scans

   With fertility medicines, vaginal ultrasound scans check how the eggs are developing. The HFEA says that if too many follicles (the sacs that hold the eggs) develop, the cycle will have to be cancelled because of the risk of a multiple pregnancy.

4. Timing

   You'll either be given a hormone injection to help release the egg, or have tests to check when you're about to ovulate.

5. Sperm wash

   The male partner usually gives a sperm sample at the clinic on the day. ReproductiveFacts says washing it to concentrate the sperm can take up to 2 hours.

6. Insemination

   A speculum (a smooth, tube-shaped tool) holds the vagina open, and a thin, flexible tube (catheter) passes the sperm into the womb. The NHS says this usually takes no more than 10 minutes and is not usually painful, although it can be a bit uncomfortable and you may have cramping for a short time. You can go home after a short rest.

7. Pregnancy test

   You'll be told when to take a pregnancy test. The HFEA says try not to test early, as the result may be misleading.

If IUI does not work, the HFEA says many people have several cycles before a successful pregnancy. After six cycles without success, your doctor may want to run some tests and, depending on the results, may advise you to consider IVF.

If you're having fertility medicine to stimulate ovulation, the NHS says to get emergency help if you have any of these, which could be severe symptoms of OHSS:

• you have difficulty breathing
• you have pain in your chest or upper back
• you're very thirsty and peeing less than usual (dehydration)
• you have swelling in any part of your body

In Pakistan, call 1122 or go to the nearest hospital emergency department. In the UK, call 999 or go to A&E (accident and emergency). Do not drive yourself: ask someone to drive you or call an ambulance, and bring any medicines you take.

The NHS also says to get emergency help immediately if you have a combination of: a sharp, sudden and intense pain in your tummy; feeling very dizzy or fainting; feeling sick; looking very pale. With an ectopic pregnancy, these symptoms could mean that a fallopian tube (one of the tubes connecting the ovaries to the womb) has split open (ruptured), which is very serious and needs surgery as soon as possible. Call 1122 in Pakistan or 999 in the UK, or go to the nearest hospital emergency department.

The NHS also says to get emergency help if you have pelvic pain (pain in the lower part of your tummy) and any of these: it's severe, getting worse, or hurts when you move or touch the area; you feel faint, dizzy or lightheaded, or pass out; you have pain in the tip of your shoulder; you have difficulty breathing; you have heavy bleeding from your vagina; you suddenly feel confused. Call 1122 in Pakistan or 999 in the UK, or go to the nearest hospital emergency department.

Contact your fertility clinic as soon as possible, the NHS says, if you have pain and bloating in your tummy (abdomen), are feeling and being sick, feel faint, or are coughing up blood: these could be symptoms of OHSS. If you also have any of the emergency signs above, get emergency help instead. MCI patients can call +92 348 335 6595, 9am to 8pm: for these symptoms, please call rather than send a message. Outside these hours, or if you cannot reach us, go to a hospital emergency department. In the UK, you can also call NHS 111.

Ectopic pregnancy. The NHS says symptoms can include a combination of: a missed period and other signs of pregnancy; tummy pain low down on one side; vaginal bleeding or a brown watery discharge; pain in the tip of your shoulder; discomfort when peeing or pooing. If you have a combination of any of these symptoms and you might be pregnant, get medical advice right away, even if you have not had a positive pregnancy test: contact your fertility clinic or a doctor (in the UK, your GP or NHS 111). If you also have any of the emergency signs above, get emergency help instead.

For patients in Pakistan (also for Pakistanis working in the Middle East), IUI at MCI costs Rs 6,000, and your first consultation, ultrasound scan and semen analysis are free. Ask about the cost of any fertility medicines or other tests your doctor advises. Families on low incomes can ask about reduced fees at their consultation; we do not offer instalment plans. See all costs.