Patient guides
Plain-English guides to male infertility, andrology and reconstructive urology, written by Mr Maj Shabbir FRCS(Urol). They explain the options, the evidence and the trade-offs, so you can come to a consultation with the right questions.
Comparing your options
Side-by-side explanations of the decisions men most often have to make.
Andrologist vs urologist: what is the difference?
In the UK, andrology is a sub-specialty of urology. Here is what an andrologist does, when it is worth seeing one, and how to judge who to see.
Read the guidemicroTESE vs TESA vs PESA: choosing the right sperm retrieval
PESA, TESA and microTESE all collect sperm directly from men who have none in the ejaculate. The right one depends on why there are no sperm, not on which sounds most advanced.
Read the guideVasectomy reversal or sperm retrieval with IVF?
After a vasectomy there are two ways to have a child with your own sperm: rejoin the tubes and conceive naturally, or retrieve sperm surgically for ICSI. Which suits you depends as much on your partner as on you.
Read the guideUrethroplasty vs urethrotomy vs Optilume
Three treatments for urethral stricture, with very different trade-offs between how easy the treatment is now and how long the result lasts. The right choice depends mainly on where your stricture is, how long it is and what has been done before.
Read the guideVaricocele surgery vs embolisation: which is right for you?
Both are legitimate ways to treat a varicocele. They differ in who performs them, how you recover and which risks you accept — and neither should be done unless the varicocele genuinely needs treating.
Read the guideQuestions patients ask
Straight answers to the questions I am asked most in clinic.
Can a man with azoospermia father a child?
Often, yes. A result showing no sperm tells you what is happening, not why — and the reason decides which route to fatherhood is open to you.
Read the guideTestosterone replacement and fertility: what TRT does to sperm
Testosterone replacement switches off sperm production, often completely. In most men this reverses after stopping, but slowly and not always — so it needs planning, not guesswork.
Read the guideVasectomy reversal success rates: does time since vasectomy matter?
Sperm return after most reversals performed within 20 years of a vasectomy, but pregnancy rates are lower and fall as the years pass. Here is what the UK figures show and what else changes the odds.
Read the guideSemen analysis results explained
A semen analysis is usually the first fertility test a man has. Here is what each line of the report means — and why one abnormal result is never the final word.
Read the guideNon-surgical treatment for Peyronie’s disease
Not every bend needs an operation, and not every treatment sold for Peyronie’s disease works. This guide sets out what non-surgical treatment can realistically achieve, in which phase, and when surgery becomes the better choice.
Read the guideSpeak to my team
Appointments at The Shard and Canary Wharf are arranged by my PA, Jeanette Bush. Tell us briefly what the problem is and we will find the right clinic slot for you.