Is cais (complete androgen insensitivity syndrome): grade 1 (pais) - the individual has male genitals and is likely to be infertile. Grade 2 (pais) - there are predominantly male genitals, which are small. The urethra may not end at the end of the penis, but at the underside of the shaft or somewhere else (hypospadia). The child may have undescended (internal) testes (testicles) - known as cryptorchidism. Grade 3 (pais) - there are predominantly male genitals, however they are very small. Possible hypospadias and internal (undescended) testes. viagra price new zealand Grade 4 (pais) - genitals are ambiguous. There may be a penis, but it is impossible to tell whether it is a clitoris or a penis (phallic structure that is indistinguishable between a penis and a clitoris). viagra sale Grade 5 (pais) - genitals are essentially female, with separate urethral and vaginal passages. The clitoris may be larger than normal. Grade 6 (pais) - the genitals are female, and there is pubic and underarm hair. Grade 7 (cais) - the genitals are female, but there is no (or very little) pubic and underarm hair. People with grade 6 or 7 are visibly indistinguishable before puberty. What are the causes of androgen insensitivity syndrome? buy generic viagra online Each embryo, whether male (with xy chromosomes) or female (xx chromosomes) starts off with the capacity to develop either a female or male reproductive system. During its first 8 weeks of life the embryo has non-specific genitals - in other words, they are all the same. viagra sales mail A few weeks later, a healthy xy fetus' non-specific genitals develop into male ones due to the effects of androgens (male hormones) - the androgens are produced by the testes. (an embryo is an unborn, developing child during the first three months of pregnancy, after that it is called a fetus). buy cheap viagra The genes that produce androgen receptors are faulty in people with ais (androgen insensitivity syndrome). viagra soft pas cher Androgen (a hormone) does not work properly until it locks onto androgen receptors (receptor molecules) and cells cannot react to the androgen, or the reaction is too weak. generic viagra online kaufen Put simply - a person with ais does not have enough androgen receptors because of a gene mutation (fault, alteration). An individual with cais (complete androgen insensitivity syndrome) does not react to androgen at all, resulting in male genitals and reproductive organs failing to develop. In about 30% of cases of ais, the mutation of the androgen receptor gene first occurs in the family either when the eggs of the mother are being formed, or in one of the embryo cells soon after conception. viagra pills Experts are not sure why. buy viagra canada In other cases the mutated gene is inherited from the mother (the carrier) as part of the x chromosome. If a female baby has one faulty x chromosome she will be a carrier, because the 'good' x chromosome will balance out its effect (females have xx. generic viagra online kaufen