How is cryptozoospermia diagnosed?

In order to evaluate the quality of a sperm sample, the most important test to carry out is a semen analysis or seminogram, which allows the sample to be examined both macroscopically and microscopically.If alterations are found in the different sperm parameters, your doctor may require you to do some additional tests, including a hormonal analysis, physical exploration, and/or even an ultrasound scan. The goal is to gather as much information as possible to find the cause of infertility.

1. Sperm counting chamber

To determine the sperm count of a sperm sample, your doctor will examine the sample under the microscope aided by a counting chamber. Each chamber has a scored-in counting grid to make the sperm counting process easier.

There exist two types of sperm counting chambers nowadays:

Makler chamber

measures the quantity by millions per ml, however in cases of cryptozoospermia the count does not fit into that scale, so it becomes useless.

Neubauer chamber

It allows the specialist to accurately measure values of 10,000 spermatozoa per ml.

When a sperm specimen has cryptozoospermia, it is likely that no sperms or only a few are found under the microscope.

In these cases, the sample is centrifuged to eliminate seminal plasma and make the few sperms that are present to come into contact with the bottom of the conical centrifuge tube (this is called pellet). Then, the bottom of the tube is observed under the microscope in order to see if a sperm layer has formed.

  2.Hormonal testing

There are two hormones that play a major role in male fertility. For this reason, monitoring their levels allows us to determine if spermatogenesis (process of sperm production) is taking place normally in the testes, or if there is a prevailing condition preventing it.

These hormones are FSH (follicle-stimulating hormone), released by the pituitary gland to regulate sperm production, and inhibin B, released by the testes once sperm cells are formed.

Here is what FSH and inhibin B levels can tell us about male fertility:

Normal levels of FSH and inhibin B

Spermatogenesis is taking place normally, hence a case of obstructive cryptozoospermia.

High FSH and low inhibin B levels

Testicular failure is compromising the sperm production process. This would be a case of non-obstructive cryptozoospermia.

Low FSH and inhibin B levels

The pituitary gland is not working properly, which affects spermatogenesis directly.  This would also be a case of non-obstructive cryptozoospermia.