Cryptospermia or Cryptozoospermia isn’t a very common condition. It’s also why this particular diagnosis is commonly missed. The word crypto means hidden. This name suggests that patients who have Cryptospermia have occasional sperm in the semen. However, since the number of sperm are so few, they are extremely difficult to find and very easy to miss as well. This is a very common problem when the semen analysis is done at a general medical lab. At these places, the technicians have no experience and they don’t even know exactly how the semen analysis should be done.

The improper process

Many technicians do the microscopic analysis of the semen sample very casually. They then report that it has azoospermia or zero sperm count if they can’t see the sperm at first glance. This can actually be extremely misleading and it sends both, the doctor and the patient on a wild goose chase. It’s not surprising that many of these patients also end up with surgery they don’t need, such as a VEA (vaso epididymal anastomosis) or a testis biopsy; all this because the diagnosis wasn’t made correctly.

This is exactly why it’s very important that before the sample is labeled as azoospermia, the lab technician should first centrifuge the sperm sample and then look at the pellet very carefully for the presence of sperm. Just as it’s important for technicians to be aware of this particular condition, it’s important for the patients to be aware of it too.

What patients should do

They should be vigilant and if their semen analysis report shows as azoospermia, they should:

• Provide a sequential ejaculate- you provide 2 samples for analysis. The end sperm sample should be given to the lab 1-2 hours after the first one has been given. In most instances, this may contain some sperm even if the first one doesn’t like its “fresher”
• Be very specific and request the lab to centrifuge the semen sample and then check the pellet for sperm. Good labs will routinely do this, but others don’t follow this procedure.

This process makes a very big difference because even if a few sperm are found in your semen sample, the best course of treatment would be ICSI and there isn’t any need to waste any time and energy on any ineffective surgical therapy or medical treatment.

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