Honest IVF Services in London

Starting a fertility journey can feel overwhelming, and you do not have to work it out on your own. Our London clinic assesses both male and female fertility problems, with particular expertise in the male half of the picture, which is often investigated less thoroughly than it should be. We aim to restore natural fertility wherever that is realistically possible, to explain clearly what the evidence supports, and to tell you plainly when a treatment is unlikely to help. Consultations are available at The Shard, Canary Wharf and Guy's Hospital.

What IVF actually involves

In vitro fertilisation (IVF) is a form of assisted conception. Eggs are collected from the ovaries and fertilised with sperm in a laboratory. The resulting embryos are monitored for a few days, and one is then transferred into the uterus with the aim of achieving a pregnancy. A cycle usually runs over several weeks, from the start of ovarian stimulation through egg collection to embryo transfer, although the timing varies from one person to the next.

IVF is commonly considered where there are blocked fallopian tubes, ovulation disorders, endometriosis, male factor infertility, or infertility that remains unexplained after proper investigation. It is not automatically the first step. In some couples the underlying problem is treatable in its own right, and fertility improves without assisted conception. Working out which of those two situations you are in, before anyone books a cycle, is the point of a careful assessment.

What we mean by honest IVF

Starting fertility treatment can feel overwhelming, and the information around it is often confusing. Our position is straightforward. We give you a clear, evidence-based assessment of where you stand, we aim to restore natural fertility wherever that is realistically possible, and we say plainly when a treatment is unlikely to help you.

That includes being honest about the limits of what anyone can promise. Outcomes depend on age, egg quality, sperm quality and the underlying diagnosis, and no clinic can guarantee a pregnancy. What we can do is explain how each of those factors applies to you and what the evidence says about the options in front of you.

Mr Maj Shabbir is a member of the core guideline committee for the NICE fertility problems guideline, and our advice follows the same national guidance rather than commercial preference. We are also clear about what we do ourselves and what we advise on. The surgical and medical management of male fertility is carried out by our consultants; where a laboratory IVF or ICSI cycle is needed, we work with licensed fertility units and guide you through the decisions involved.

The male half of the assessment

Male factor problems contribute to a substantial proportion of couples’ infertility, and they are often assessed less thoroughly than the female side. Our particular expertise is in that half of the picture. A semen analysis is the starting point, but an abnormal result on its own is not a diagnosis. It needs interpreting alongside examination, hormone testing and, where relevant, imaging or genetic testing.

This matters because some male causes are correctable. A varicocele may be treatable. A hormonal problem may respond to medical treatment. An obstruction may be surgically reversible. Where sperm are absent from the ejaculate entirely (azoospermia), the distinction between an obstruction and a production problem changes the treatment completely, and getting that distinction right before an IVF cycle is booked can change what the cycle needs to involve.

Services we offer or can advise on

We provide a range of fertility assessments and treatments in London, tailored to your circumstances rather than to a fixed pathway.

Assessment

An initial fertility assessment is a full consultation for both partners, covering medical history and examination, hormone profiling, ultrasound scans and semen analysis, so that a treatment approach can be based on evidence rather than assumption. Where they are indicated, we arrange more detailed investigations: genetic screening, MRI, and sperm DNA fragmentation testing. We order these when the result would change the plan, not as routine.

Improving male fertility

Where sperm count or quality can be improved, we start there. This may involve lifestyle and general health measures, treatment of an underlying condition, or varicocele repair by microsurgery or embolisation.

Obstructive azoospermia

Where the testicles produce sperm but the passage out is blocked, we identify the level of the blockage and treat it. Options include ejaculatory duct resection, vasectomy reversal, and surgical sperm retrieval by PESA or TESA.

Non-obstructive azoospermia

Where sperm production itself is impaired, microdissection testicular sperm extraction (micro-TESE) is used to search the testis for small areas of sperm production. Our consultants also take on redo cases where a previous retrieval attempt elsewhere was unsuccessful.

IVF and ICSI

A standard cycle involves controlled ovarian stimulation, egg retrieval, fertilisation and embryo culture in the laboratory, and embryo transfer. ICSI, in which a single sperm is injected directly into an egg, is used in selected situations, most often significant male factor infertility or where sperm has been retrieved surgically. We advise you on when ICSI is genuinely indicated over conventional IVF, and when it is not.

Freezing and fertility preservation

Eggs can be collected and frozen for future family planning. Good quality embryos can also be frozen for use in later cycles, which gives more flexibility from a single stimulation. For anyone facing medical treatment that may affect fertility, including cancer therapy, we can advise on preservation options and arrange them before treatment starts wherever the timing allows.

ICSI, PICSI, IMSI and treatment add-ons

Fertility clinics offer a long list of optional extras alongside a standard cycle. We recommend only what the evidence supports, in line with HFEA guidance and NICE and international recommendations. Where an add-on has not been shown to improve the chance of a live birth, we will say so, and we will not suggest it simply because it is available. This applies to ICSI itself as much as to newer techniques: it is a useful procedure in the right circumstances and unnecessary in many others.

How to choose a fertility clinic

If you are comparing clinics, these are the things worth asking about.

• Experience and reported outcomes. Ask how often the team treats your particular problem, and how outcomes are reported.
• An individualised plan. Every fertility history is different. The plan should be built around your findings, not around a standard package.
• Laboratory standards. The embryology laboratory and the techniques it uses have a real influence on results.
• Emotional support. Fertility treatment is demanding. Access to counselling and support should be part of the service, not an afterthought.
• Clear communication. Procedures, costs and realistic expectations should all be explained before you commit.
• Regulation. Any clinic carrying out IVF in the UK must be licensed by the Human Fertilisation and Embryology Authority (HFEA), which publishes information on licensed clinics.

When to seek advice sooner

Most fertility problems are not urgent, and there is usually time to investigate properly. As a general guide, it is reasonable to seek assessment after a year of trying to conceive without success, or sooner if you are over 35, if periods are irregular or absent, or if there is a known problem such as previous testicular surgery, undescended testicles, chemotherapy or a previous abnormal semen analysis.

Some symptoms should not wait. Seek same-day medical attention for sudden severe pain or swelling in a testicle, which can indicate testicular torsion and needs assessment within hours. A new painless lump in a testicle should be examined promptly. If you are in an ovarian stimulation cycle and develop severe abdominal pain, persistent vomiting, a rapidly swelling abdomen, breathlessness or a marked drop in urine output, contact the treating unit immediately or attend an emergency department, as these can be signs of ovarian hyperstimulation syndrome.

Appointments and referrals

Consultations are available with Mr Maj Shabbir, Consultant Urological Surgeon and Clinical Lead of The Andrology Centre and past National Chair for Andrology at BAUS; Ms Raveen Kaur Sandher, Consultant Urological Surgeon. Both practise at Guy’s & St Thomas’, named by Newsweek in 2025 as the number one urology service in Europe.

We see patients at HCA at The Shard (SE1 9BS), HCA at Canary Wharf (E14 5NR) and HCA at Guy’s Hospital (SE1 9RT). If you are self-funding you do not need a GP referral and can book directly. If you are using private medical insurance, your insurer will usually require a referral, so it is worth checking with them before you book.

To arrange an appointment, call +44 7889 318584, Monday to Friday, 8am to 4pm, or email contact@theandrologycentre.co.uk. If you would like your partner assessed at the same time, please say so when you book, so that both appointments can be arranged together.

Frequently asked questions

References and further reading