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      Links among inflammation, sexual activity and ovulation : Evolutionary trade-offs and clinical implications


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          Inflammation in healthy sexually active women decreased at midcycle, around ovulation, which may have evolved to promote conception.


          Background and objectives: We examined a mechanism that may coordinate trade-offs between reproduction and immune response in healthy women, namely, changes in inflammation across the ovarian cycle.

          Methodology: We investigated C-reactive protein (CRP), an inflammation marker, across two consecutive ovarian cycles in 61 Bolivian women. Participants provided saliva samples every other day, and dried blood spots on 5–6 days spread across weeks 2–3 of each cycle. Cycles were characterized as ovulatory/anovulatory based on profiles of reproductive hormones. Participants also reported whether they were sexually partnered with a male or sexually abstinent during the study.

          Results: High early-cycle, but not late-cycle, CRP was associated with anovulation. High inflammation at the end of one cycle was not associated with anovulation in the subsequent cycle. Among ovulatory cycles, women with sexual partners had significantly lower CRP at midcycle, and higher CRP at follicular and luteal phases; in contrast, sexually abstinent women had little cycle-related change in CRP. In anovulatory cycles, partnership had no effect on CRP. CRP varied significantly with socioeconomic status (higher in better-off than in poorer women).

          Conclusions and implications: These findings suggest that the cycle-specific effect of inflammation on ovarian function may be a flexible, adaptive mechanism for managing trade-offs between reproduction and immunity. Sociosexual behavior may moderate changes in inflammation across the ovarian cycle, suggesting that these shifts represent evolved mechanisms to manage the trade-offs between reproduction and immunity. Clinically, these findings support considering both menstrual cycle phase and sexual activity in evaluations of pre-menopausal women’s CRP concentrations.

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          Most cited references78

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          C-reactive protein: a critical update.

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            Timing of sexual intercourse in relation to ovulation. Effects on the probability of conception, survival of the pregnancy, and sex of the baby.

            The timing of sexual intercourse in relation to ovulation strongly influences the chance of conception, although the actual number of fertile days in a woman's menstrual cycle is uncertain. The timing of intercourse may also be associated with the sex of the baby. We recruited 221 healthy women who were planning to become pregnant. At the same time the women stopped using birth-control methods, they began collecting daily urine specimens and keeping daily records of whether they had sexual intercourse. We measured estrogen and progesterone metabolites in urine to estimate the day of ovulation. In a total of 625 menstrual cycles for which the dates of ovulation could be estimated, 192 pregnancies were initiated, as indicated by increases in the urinary concentration of human chorionic gonadotropin around the expected time of implantation. Two thirds (n = 129) ended in live births. Conception occurred only when intercourse took place during a six-day period that ended on the estimated day of ovulation. The probability of conception ranged from 0.10 when intercourse occurred five days before ovulation to 0.33 when it occurred on the day of ovulation itself. There was no evident relation between the age of sperm and the viability of the conceptus, although only 6 percent of the pregnancies could be firmly attributed to sperm that were three or more days old. Cycles producing male and female babies had similar patterns of intercourse in relation to ovulation. Among healthy women trying to conceive, nearly all pregnancies can be attributed to intercourse during a six-day period ending on the day of ovulation. For practical purposes, the timing of sexual intercourse in relation to ovulation has no influence on the sex of the baby.
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              Ecological immunology: costly parasite defences and trade-offs in evolutionary ecology.

              S Verhulst (1996)
              In the face of continuous threats from parasites, hosts have evolved an elaborate series of preventative and controlling measures - the immune system - in order to reduce the fitness costs of parasitism. However, these measures do have associated costs. Viewing an individual's immune response to parasites as being subject to optimization in the face of other demands offers potential insights into mechanisms of life history trade-offs, sexual selection, parasite-mediated selection and population dynamics. We discuss some recent results that have been obtained by practitioners of this approach in natural and semi-natural populations, and suggest some ways in which this field may progress in the near future.

                Author and article information

                Evol Med Public Health
                Evol Med Public Health
                Evolution, Medicine, and Public Health
                Oxford University Press
                16 December 2015
                : 2015
                : 1
                : 304-324
                1The Kinsey Institute, Indiana University, Morrison Hall 313, 1165 E 3rd Street, Bloomington, IN 47405, USA;
                2The Center for Integrative Study of Animal Behavior, Indiana University, Bloomington, IN 47405, USA;
                3Laboratory for Comparative Human Biology, Department of Anthropology, Emory University, 214 Anthropology, 1557 Dickey Drive, Atlanta, GA 30322, USA;
                4Evolutionary Anthropology Laboratory, Department of Anthropology, Indiana University, Student Building 130, 701 E. Kirkwood Avenue, Bloomington, IN 47405, USA
                Author notes
                *Corresponding author. The Kinsey Institute, Indiana University, Morrison Hall 326, 1165 E 3rd Street, Bloomington, IN 47405, USA. Tel: +812-856-9036; E-mail: lorenzt@ 123456indiana.edu
                © The Author(s) 2015. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 2 June 2015
                : 12 November 2015
                Page count
                Pages: 21
                Original Research Article


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