Male Fertility Treatment in London

If you and your partner have been trying for a baby without success, male factors need to be assessed properly, not as an afterthought. A male factor is involved in around half of couples with fertility problems, and many of the causes have a specific diagnosis and a specific treatment. At The Andrology Centre you are seen by a consultant who specialises in male infertility, tested for a reason rather than by routine, and given a plain explanation of what the results mean before anything is recommended.

Why the man should be assessed too

In couples having difficulty conceiving, a male factor is involved in around half of cases. Despite that, male fertility is often overlooked. Many fertility centres are built around the female partner and do not have a specialist in male infertility on the team, so a sperm problem is treated as a number on a report rather than as a symptom with a cause worth investigating.

We take the opposite view. An abnormal semen result is a starting point, not a diagnosis. It can point to a hormonal problem, a varicocele, a blockage, an ejaculatory problem, a genetic cause or a lifestyle factor, and several of those can be corrected. At The Andrology Centre you see a consultant who specialises in male infertility, who is involved in writing national practice guidelines and who teaches other specialists.

Finding a treatable cause matters for the couple as a whole, because it can change what is needed on the female side as well. Where assisted conception is genuinely the right route we will say so plainly, but the aim is to restore natural fertility wherever that is realistic, rather than turning to IVF or ICSI as the first step.

When to have a male fertility assessment

The usual advice is to seek assessment after 12 months of regular unprotected sex without conception, or after 6 months if your partner is over 35. You do not need to wait that long if there is a reason to look sooner.

• Previous testicular surgery, an undescended testis in childhood, or testicular torsion
• Previous chemotherapy or radiotherapy
• A previous vasectomy, where your circumstances have changed
• Symptoms of low testosterone, or current or past use of testosterone or anabolic steroids
• Difficulty ejaculating, a very small ejaculate volume, or a dry orgasm
• A swelling, ache or lump in the scrotum

Not every finding needs treatment. A small varicocele that is not affecting your semen results, or a mildly abnormal result that corrects itself on a repeat test, is often best left alone, and we will tell you when that is the case rather than treating for the sake of it.

What happens at your assessment

The assessment is thorough, structured and confidential.

• Initial consultation. A detailed discussion of your medical history, medication, lifestyle factors, previous fertility attempts and any symptoms.
• Physical examination. Examination of the testes and reproductive organs, where this is required.
• Laboratory testing. Semen analysis and a hormone profile.
• Diagnostic imaging. Ultrasound scans performed by expert radiologists. If a structural abnormality is suspected, an MRI may be needed.
• Results review and plan. A clear explanation of what the findings mean, and a discussion of the treatment options that suit your situation.

Male fertility tests we use

We use a range of tests to identify the underlying cause rather than simply confirming that there is a problem.

Semen analysis

A laboratory assessment of sperm count, concentration, movement (motility) and shape (morphology), which gives an overall picture of semen quality. Results vary between samples, so a single abnormal result is usually repeated before conclusions are drawn.

Hormone blood tests

Measurement of testosterone, FSH, LH and prolactin to assess the hormonal balance that regulates sperm production and sexual function.

Genetic screening

Where appropriate, testing for chromosomal abnormalities or inherited conditions that affect fertility. These results also matter for any children conceived, so they are discussed carefully before testing.

Post-ejaculation urinalysis

Used to detect retrograde ejaculation, where semen passes backwards into the bladder instead of leaving the body.

Imaging

Scrotal and testicular ultrasound to look for a varicocele, obstruction or a testicular lesion, and an MRI scan in selected cases to assess congenital or structural problems.

Sperm DNA fragmentation test

Assesses the quality of the DNA carried by the sperm, which can affect fertility even when a standard semen analysis looks normal. We use this test only when it is indicated and supported by current evidence.

Treatment for male infertility

Treatment depends on the diagnosis and on your wider health, so the plan is put together after the results are in, not before.

Lifestyle and nutritional optimisation

Practical guidance on weight, stopping smoking, diet and the other modifiable factors that affect sperm production.

Medical therapy

Correct, evidence-based use of fertility supplements, and hormonal treatment for low testosterone or other endocrine disorders that impair sperm production. Note that taking testosterone itself suppresses sperm production and can make fertility worse, which is why hormone problems in men who want children need specialist handling.

Varicocele treatment

For men with a clinically significant varicocele, minimally invasive treatment by radiological embolisation or sub-inguinal microsurgical ligation, aimed at improving semen parameters. Our guide to varicocele embolisation vs surgery compares the two approaches.

Treatment for ejaculatory disorders

Management of retrograde ejaculation and other ejaculatory problems, including the use of specialist devices where these are appropriate.

Microsurgical vasectomy reversal

For men whose circumstances have changed. Our surgeons are leading surgical tutors who train other surgeons in microsurgical technique.

Surgery for obstructed ejaculatory ducts (TURED)

A minimally invasive procedure to open obstructed ejaculatory ducts where these are the cause of the problem.

Simple surgical sperm retrieval

Needle techniques such as percutaneous epididymal sperm aspiration (PESA) and testicular sperm aspiration (TESA), used in men with an obstructed system or an ejaculatory problem.

MicroTESE

Complex microsurgical sperm retrieval for men with abnormal testicular function, where sperm are hardest to find. Our specialists have trained a generation of surgeons in this technique.

Assisted reproductive techniques

Where assisted conception is needed, we coordinate your care with fertility clinics for IVF or ICSI, and make sure the male side has been properly treated first.

How to improve sperm health

Medical treatment is often needed, but several things are within your control and are worth doing alongside it. Sperm take roughly three months to develop, so changes you make now tend to show up in a semen test a few months later rather than immediately.

• Keep to a healthy weight
• Stop smoking, and avoid recreational drugs
• Limit alcohol
• Manage stress
• Exercise regularly, without excessive heat exposure
• Eat a balanced diet rich in antioxidants
• Avoid prolonged heat, such as saunas and hot tubs
• Get enough sleep

Being assessed early gives you more options, because some causes are easier to treat before they have been present for years.

Your consultants

Both of our fertility specialists practise at Guy’s & St Thomas’, named by Newsweek in 2025 as the number one urology service in Europe.

• 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.

You will see an experienced specialist rather than a rotating team, in a confidential consultation, with a personalised plan, transparent pricing agreed before anything goes ahead, and follow-up for as long as you need it. Fertility problems are emotionally difficult, and we try to keep the process calm, private and clearly explained.

Clinics, referrals and appointments

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 paying for your own care you do not need a GP referral. If you are using private medical insurance, your insurer will usually require one, and it is worth confirming your cover before booking.

To arrange an appointment, call +44 7889 318584 between 8am and 4pm, Monday to Friday, or email contact@theandrologycentre.co.uk. If your partner is also being investigated, bring any results you already have, as they often save repeating tests.

Frequently asked questions

References and further reading