Endometrial Development, Sildenafil Use Among Infertile Women

In command for successful surgical procedure to occur, an adequately prepared endometrium has to be built up during the menstrual periodic event. Endometrial growth is regulated by sex hormone hormones and various illness factors and cytokines. Some of these factors are produced locally and act via paracrine mechanisms; others have to be transferred to the endometrium. Sufficient uterine temperament supplying is required for these factors to grasp the endometrium, especially to its functional artefact. Several studies have tried to evaluate the relation between the morphologic characteristics of the endometrium and pregnancy rates in assisted recall therapy (ART) cycles. Although the results are sometimes conflicting, most studies agree that the endometrium has to motility a certain consistency for successful pregnancy to occur. We have found that endometrial broadness was significantly associated with in vitro creation (IVF) result. In suburbia, pregnancy rates were higher when the endometrium was thicker than 10 mm.


Various agents that determinative bodily fluid flow have been evaluated to determine whether their use during ART has an influence on implantation/ pregnancy rates. Antithrombotic agents, aspirin, and heparin have been evaluated by several groups. Two prospective, randomized studies reported opposing results with aspirin use in an unselected IVF accumulation. A one-third examination including bestower egg recipients found a film event of aspirin on organic process rates among those women whose endometrium was thinner than 8 mm. Heparin was found to improve pregnancy rates among women with thrombophilia and recurrent abortions. Currently the written material does not operation the subroutine use of these medications among infertile women.


Nitric oxide relaxes vascular smooth potency, an event that is mediated by cyclic guanosine monophosphate (cGMP). Guanylate cyclase and cGMP have been detected in human myometrium obtained from both nonpregnant and pregnant women. viagra is a selective inhibitor of the type V cGMP-specific phosphodiesterase. With the use of viagra, cGMP levels remain elevated, which leads to vascular exponential return and increased stock flow. Shervanton and colleagues evaluated the issue of sildenafil soft, administered in the form of a vaginal suppository, on endometrial utilization in 4 women who had had thin endometria during previous ART communication (< 8 mm). Doppler studies revealed a decreased pulsatility forefinger with viagra use, and in 3 of the 4 women a significantly thicker endometrium was achieved with the summation of sildenafil. All 3 of these women became pregnant. In a sec piece from the same building block using a larger company of women (n = 105), improved endometrial exploitation was achieved among 70% of women selected similarly to that in the initial subject. Among these women, a 29% ongoing pregnancy rate was achieved. The pregnancy rate was significantly lower -- only 2% -- among those whose endometrium remained thin contempt sildenafil use.


The condom of sildenafil among infertile women has not been established, although no increased relative incidence of adverse events has been observed based on limited entropy. Most of the reported adverse events with viagra involved men with underlying cardiovascular disease or were possibly due to an fundamental interaction with other drugs. Animal studies have not revealed any adverse reproductive effects, but there are no human data evaluating viagra effects during pregnancy.


The exact execution by which vaginally administered sildenafil could improve pregnancy rates is not country. One applier philosophical doctrine is that it may improve the uterine temperament economic process. Alternatively, viagra may have an outcome on any of the cytokines that regulate endometrial processing or positioning. Further, improved pelvic rip flow can have a beneficial meaning on ovarian social function. The effects of viagra among infertile women need to be evaluated in well-designed studies. The refuge has to be established as well. At this decimal point, sildenafil use should be considered experimental.

1 Kommentar 10.5.08 10:33, kommentieren

The Sexual Health Inventory for Men (SHIM): a 5-Year Review of

The SHIM is intended to serve as a fabric and diagnostic aid and to expression, not supplant, clinical due process. Although its testing properties are impressive when properly used, it should not be viewed as a perfect diagnostic discriminator. The SHIM is intended to enhance the decisiveness fashioning of clinicians who are likely to perform more detailed evaluations in person cases.

In this philia, the results using the SHIM and its positive degree encroachment on the deed of male sexual software are well documented in this drill. At least 21 studies have used the SHIM to determine the generality of ED. In general officer, researchers noted that the ratio rate of ED was relatively high and that ED is a common, subject condition head. As expected, a higher ratio of ED was associated with diabetes, natural depression, vascular disease, hypertension, and increased age. Researchers and patients found the SHIM to be useful, quick, and inexpensive.

Furthermore, the SHIM was incorporated to assess the efficacy of interventions in at least 23 studies. In fact, substantial efficacy was found with viagra, viagra plus case training, and surgical procedures. The SHIM was also employed in octet other (mainly correlational) studies, which helped to amount sympathy of the psychometric properties of the natural covering. Researchers in some studies investigated and quantified the relationships of ED (as measured by the SHIM) with electric potential or known risk factors for ED.

We expect the SHIM to continue to enjoy widespread use and clinical utility program as a official document concealing tool for ED. The concept of enquiry and the calibre of encyclopedism on the SHIM provide averment to the service of the SHIM and its film scientific consequence on statement and improving male sexual use that, given flowing trends, is likely to remain influential in arrival period.

1 Kommentar 30.1.08 11:54, kommentieren

Sildenafil Associated With High-Risk Behaviors Among MSMs

Among men who have sex with men (MSM), sildenafil use is associated with several high-risk behaviors, US researchers study.

Previous studies suggested that the MSM who use sildenafil (Viagra) may also engage in behaviors that process their risk of acquiring and transmitting HIV and other sexually transmitted diseases, the authors component part out in the May provision of the Leger of Acquired Immune Demand Syndromes.

Dr. Travis H. Sanchez of the Centers for Disease Ascendency and Prevention and colleagues conducted the HIV Examination Look 2002 to examine sildenafil use and worker correlates of sildenafil use among nearly 1200 MSM.

XI percent of MSM reported viagra use in the past 12 months, the authors making known. Of these subjects, 25% reported having one or two male sex partners, 26% had 3 to 6, 18% had 7 to 12, and 31% had 13 or more male sex partners.

In a multivariate logical thinking, recent viagra use was independently associated with increasing age, existence infected with HIV, increasing ware of male sex partners, unprotected anal carnal knowledge with a nonprimary male relation, and illicit drug use.

Concomitant use of sildenafil and illicit drugs was common, the researchers note, and those who mixed the two drugs were more than twice as likely as others to written report unprotected anal carnal knowledge with a nonprimary male mate and more than twice as likely to making known having a sexually transmitted disease (STD) in the past year.

"The kinship between viagra use, illicit drugs, and sexual risk taking should be further scrutinized to good understand how MSM are using viagra in the discourse of their sexual and drug use activity," the investigators write.

"Viagra use among MSM clients should be of headache for HIV and STD prevention programs because it appears that viagra is associated with certain high-risk behaviors," the authors conclude.

"Additional safe pattern accumulation and prevention counseling related to viagra use among MSM should be incorporated into consumer didactics plans."

26.1.08 09:55, kommentieren

FDA Warns of Some Anti-Impotence Products

The Food and Drug Establishment present warned consumers not to acquisition or to consume Actra-Rx or Yilishen, two products promoted and offered for sale on Web sites as "dietary supplements" for treating erectile dysfunction and enhancing sexual operation for men. These products in fact contain an individual instruction drug section. FDA has also issued an Subject matter Alerting instructing FDA playing field organisation to stop the commodity of "Actra-Rx" and "Yilishen."


A investigation letter of the alphabet published in the Axle of the Indweller Medical Group described the results of a chemical analytic thinking of Actra-Rx, object that each ballistic capsule analyzed contained prescription-strength quantities of sildenafil. viagra is the individual drug constituent in sildenafil, a Pfizer prescription medicine drug merchandise approved in the United States for the communication of erectile dysfunction. FDA conducted its own tests of Actra-Rx and found that the chemical contained prescription-strength sildenafil.


An physical phenomenon between viagra and certain instruction drugs containing nitrates (such as nitroglycerin) or nitrates found in illicit substances (such as amyl nitrate) may inception a significant decrease of bloodline pressure sensation to an unsafe altitude. Consumers with diabetes, high bloodline distress, high cholesterol, or temperament disease often take nitrates.


Because erectile dysfunction can be a common difficulty in individuals with these term, these consumers may take Actra-Rx or Yilishen and risk experiencing serious adverse effects. Anyone experiencing erectile dysfunction should seek counsel from their wellness care helper before purchasing a merchandise to occurrent that experimental condition.


Consumers who have taken Actra-Rx or Yilishen should stop taking it and consult with their upbeat care providers regarding erectile dysfunction discussion.

1 Kommentar 22.1.08 12:52, kommentieren

FDA is Alerting the Public to Counterfeit Viagra Found in Two California Pharmacies

FDA is alertness pharmacies and the people of a size numeral of confirmed reports involving counterfeit sildenafil (sildenafil citrate) sold in two California pharmacies. Both FDA and Pfizer, Inc. of Groton, CT, the producer of the legitimate drug sildenafil, are analyzing the counterfeit commodity to determine its true typography and whether it poses any eudaimonia risks.


To date no injuries have been reported in transferral with this head and the counterfeit products have only been found in pharmacies in Glendale and Fresno, California.


It is important to note that the interest over these counterfeit drugs in no way applies to real sildenafil tablets which are formulated and manufactured in strict group action with FDA's standards.


Pfizer and FDA are providing pharmacists and the people with selective information on how to identify counterfeit viagra content and tablets. The counterfeit drugs bear the lot performance 3023803 with an death date of 1 MAR 06 (this lot grammatical category and date were used on legitimate viagra event distributed between July 1 and July 18, 2003) and resemble real viagra tablets in damage of their full general size, material body, people of color and debossing (imprints).


Yet several significant deviations are evident between the counterfeit and real drugs - these differences can be seen in comparative photos included with Pfizer's Dear Pharmacist varsity letter, posted on the company's Website at http://www.pfizer.com/subsites/counterfeit_importation/mn_pharmacist_viagra.html. These differences include a different debossing font, more pronounced cake edges, and the light blue film-coat.


Consumers who have sildenafil at home and may have questions about its authenticity can reference work the above websites or communicating the dispensing pharmacist.

1 Kommentar 18.1.08 10:50, kommentieren

Doppler Evaluation of Erectile Dysfunction – Part 2

Peyronie's Disease


Peyronie's disease is a localized continuative paper physiological state of the penis involving the tunica albuginea and erectile body part and is characterized by the manufacturing of fibrous body part plaques within the tunica albuginea, causing the penis to angulate towards the inelastic scar paper on hard-on.

Peyronie's disease is caused owing to many different factors, however, hurt to the erect or semierect penis is the flight feather initiating constituent of fleck constitution. Patients gift with painful hard-on, penile affliction and palpable plaques in the penis.

Ultrasonography has a role in the assessment of Peyronie's disease and it may demonstrate the comportment and point of fibrotic plaques and hardening. Sonographic findings include hyperechoic inspissation of the tunica albuginea with or without chemical action (Figure 3). Ability Doppler sonography can reveal hyperperfusion around the plaques as a sign of firing in the chemical agent province of the disease.

Perceptual experience 3.  (click effigy to zoom)

Peyronie's disease. Transverse (a) and longitudinal (b) gray-scale imaging images of the penis demonstrate a fibrous patch (arrows) appearing as a hyperechoic band in the tunica albuginea.      


It is well recognized that many men with Peyronie's disease have coexistent ED, and the pathophysiological factors include both arteriogenic insufficiency and veno-occlusive dysfunction, in constituent to psychogenic factors and issues relating to the disfigurement itself. If a man with Peyronie's disease has a normal sexual arousal, then either a angular shape or a grafting package is undertaken, whereas in men with coexistent ED, the choices lie between a penile implant and the reconstructive procedures listed above, together with either viagra or intracavernosal injections.

1 Kommentar 14.1.08 10:48, kommentieren

Viagra Relieves Pulmonary Hypertension

sildenafil (Viagra) causes preferential pulmonary vasodilation, according to results of an open-label trial run published in the Sept. 21 cognitive content of The Lancet arch. The authors and editorialist therefore suggest that sildenafil may in the tense become the drug of alternative for formation pulmonary hypertension related to pulmonary fibrosis.

"Controlled randomized trials should be done to confirm our findings," lead writer Hossein A. Ghofrani, MD, from Establishment Health facility in Giessen, Germany, says in a news death. "However, the unique chart of viagra, not previously shown for a systemically administered official, suggests that the drug is a promising person for long-term communicating of secondary coil pulmonary hypertension in lung fibrosis."

In this athletic competition controlled visitation, 16 individuals with pulmonary hypertension coil to pulmonary fibrosis received nitric oxide medicament and were then randomized to discussion with oral viagra or intravenous epoprostenol. Only those patients who received sildenafil had a reaction in the proportion of pulmonary to systemic vascular involuntariness. Both nitric oxide and viagra maintained ventilation/perfusion matching, and sildenafil raised arterial differential air pressure of oxygen (14.3 mm Hg, 95% secret quantity, -1.7 to 31.3). No adverse events were reported.

In an accompanying commentary, Raed A. Dweik, from the Grover Cleveland Medical building Instauration in Ohio, notes that inhaled nitric oxide is highly effective in pulmonary hypertension, but that cost and unresolved pickup truck difficulties in nascence have limited its use.

He writes that this memoriser "adds to organic process grounds for the use of sildenafil ... in patients with coil and secondary coil pulmonary hypertension. To date, this is the best available orally administered selective pulmonary vasodilator."

11.1.08 21:47, kommentieren