Starset Society 中文镜像站

未来系列:人造子宫——新技术如何重新定义人类生殖

FUTURES: Artificial Wombs – How new technology may be redefining human reproduction

by A’liya Spinner

Baby on Board

培养舱内的婴儿

Millie quiets the GPS as she turns the car into the lot, parking next to a silver sedan and turning off the engine. The flat stretch of asphalt is relatively empty; the few other cars she sees probably belong to the employees. After a moment of verifying the address of the nondescript building, Millie climbs out of her vehicle and opens the backseat door.

米莉关掉了GPS,把车开进了停车场,停在一辆银色轿车旁边,关掉了引擎。平坦的沥青路面相对空旷;她看到的其他几辆车可能是员工的。在核实了一段时间后,米莉下了车,打开后座的门。

For someone who is six months pregnant, she’s kept a relatively slender figure, and has no trouble bending over to undo the seatbelt and pull the heavy, glass-topped contraption out of the car, unhooking its wheeled legs so that it stands and moves easily on the pavement beside her. Her flexibility and maintained shape is, of course, thanks to the fact that her pregnancy isn’t being carried out inside her womb; she glances affectionately down at the growing fetus inside the portable ectogenesis machine, checking to make sure the car ride didn’t jostle any wires or alter any of the very sensitive environmental controls. Nothing’s out of place; the baby, which has only recently started to look properly human, seems as sleepily content as ever. Satisfied, Millie locks the car, grabs ahold of the “crib’s” handlebar, and begins to gently push it up a ramp and through the sliding doors of the building.

对于一个怀有六个月身孕的人来说,她有着相对苗条的身材,她弯腰解开安全带,把这个沉重的玻璃顶的装置拉出汽车,卸下它的轮式腿,这样它就能在她身边的人行道上轻松地站立和移动。当然,她的柔韧性和保持的体型是由于她的孩子不是在她的子宫里发育的;她深情地俯视着便携式体外培养舱里正在成长的胎儿,以确保在开车的过程中不会挤压任何电线或改变任何非常敏感的环境控制装置。没有什么是不合适的;这个最近才开始长得像人类的婴儿,看起来和以前一样昏昏欲睡。米莉很满意地锁上了车,抓住“婴儿床”的把手,开始轻轻地把它推上斜坡,穿过大楼的滑动门。

The lobby is generic and aseptic, furnished with unremarkable cushioned chairs, side tables with magazines, and a receptionist desk underneath an unlit sign: Unborns’ Daycare. The young man behind the counter looks up from his computer and smiles welcomingly.

大堂是平平无奇的、消过毒,配备着不起眼的软垫椅子、放着杂志的边桌,还有一张前台桌子,下面是一个没有灯光的标牌:Unborns日托所。柜台后面的年轻人从电脑前抬起头,热情地微笑着。

“Do you have a reservation?” He asks pulling up a new window and hitting a few keys.

“您预约了吗?”他打开一个新窗口,按了几个键。

“Yes, the thirteenth through the twentieth. Under the name ‘Greene’.” Millie taps her fingers idly on the counter, glancing over a small rack of pamphlets about the latest mobile ectogenesis machines, the benefits to external pregnancy, and guides to navigating modern parenthood.

“是的,十三号到二十号。名字叫格林。”米莉懒洋洋地用手指在柜台上轻敲着,瞥了一眼一小架子上的小册子,上面写着最新的移动体外培养舱、体外妊娠的好处,以及指导现代亲子关系的指南。

“Here it is.” He clicks and taps a few more times, then looks up at her. “You’re all checked-in and the nurse will be out shortly. If you’re comfortable sharing— what’s the occasion?”

“在这里。”他又敲了几下,然后抬头看着她。“你们都检查过了,护士马上就出来。如果你愿意分享给我的话——那是什么?”

“My husband and I are surprising our five-year-old with a trip overseas before the new baby keeps us too busy to travel,” Millie answers. She is increasingly glad that she and her partner have opted for an external womb this time around, even though her first, natural pregnancy didn’t have too many complications beyond the expected discomfort. Riding in planes, boats, and trains— as well as just walking around big European cities— for a week while six months pregnant would’ve been a hassle, and this way, she and her husband could still enjoy a little Italian wine now and then without worrying about what it might do to the baby. It was hard to overstate the convenience of ectogenesis, as well as the reassurance that she receives every morning, being able to look in and see that her child is still healthy and developing well.

米莉回答说:“我和我丈夫要给我们五岁的孩子一个惊喜,我们要去国外旅行,不然我们会忙得没有时间去旅行。”她越来越高兴,这次她和她丈夫选择了外部子宫,尽管她的第一次自然怀孕没有太多的并发症,除了预期的不适。乘坐飞机,船,火车,以及行走在欧洲的大城市当中——一个星期在怀孕6个月的孕妇看来是个麻烦,然而,她和她的丈夫仍然可以享受一点意大利葡萄酒,而不用担心它会对婴儿产生什么副作用。体外生育的便利是很难夸大的,她每天早上都能看到她的孩子仍然健康、发育良好,这让她感到放心。

A moment later, a door to the left of the desk opens and out shuffles a woman in a turquoise nurse uniform. She, like the receptionist, maintains a broad and friendly smile.

过了一会儿,桌子左边的一扇门开了,一个穿着蓝绿色护士制服的女人拖着脚步走了出来。她和接待员一样,总是面带友好的微笑。

“Greene?” She doesn’t even wait for Millie’s nod before making her way to the carriage and peering down at the baby inside. “What a handsome little one!”

“格林吗?”她甚至没等米莉点头,就走到马车前,低头看了看里面的婴儿。“多漂亮的小家伙啊!”

“Thank you. We think so, too.” Millie turns the machine to offer the handles to the nurse, which she accepts with a practiced confidence that many people didn’t have around the relatively exotice ectogenesis machines. “There’s someone in the building at all times, right? And you have our number to call if there’s any complications?”

“谢谢。我们也这么认为。”米莉转动机器,把手柄递给护士,她对培养舱已经操控地很熟练了。这是许多在相对陌生的体外发育机器周围的人面前拥有的自信。“大楼里一直都有人,对吧?”你有我们的电话号码,如果有什么问题可以打给我们吗?”

“We have trained neonatal nurses in the building all day every day,” the daycare worker replies with an affirming smile. “And your number and your partner’s number are on file. Enjoy your break, Mrs. Greene, your baby will be well taken care of.”

“我们每天都在大楼里训练新生儿护士,”日托人员报以肯定的微笑。你和伴侣的电话号码都计入档案了。休息愉快,格林太太,你的孩子会得到很好的照顾。”

Millie nods gratefully. The vacation will be a good chance to relax and recharge before coming back and “giving birth”— which, although it will no longer be as painful or time-consuming, still represents bringing new life into the world and her family. No matter what womb it’s formed in, it’s still her baby, and she’s still its mother. She kisses the glass top of the carriage goodbye, promising to return to her unconventional pregnancy soon.

米莉感激地点点头。假期将是一个很好的放松和充电的机会,然后再回来“生孩子”——尽管这不再是痛苦和耗时的,但仍然代表着给这个世界和她的家庭带来新的生命。不管它是在哪个子宫里形成的,它仍然是她的孩子,她仍然是孩子的母亲。她吻别了培养舱的玻璃顶,承诺很快就会回到非常规的怀孕状态。

What is the Artificial Womb?

什么是人造子宫?

The artificial womb, also known as ectogestation, is a general term for a number of medical devices used to keep fetuses alive ex-utero (outside of the uterus.) Primitive ectogestation machines already exist— but these machines aren’t designed to grow babies from start to finish. Rather, artificial wombs are meant to save the lives of fetuses already on the verge of being viable through natural birth. These systems, capable of replicating the function of placentas and umbilical cords, support continued gestation for premature babies, rather than putting them in prenatal emergency care with high rates of mortality and morbidity. But some researchers believe that these placental mimics can be used not only to keep fetuses alive long enough for their lungs to finish developing, but to nourish a zygote through the entirety of an artificial pregnancy.

人工子宫,也被称为外子宫,是用于使胎儿在子宫外存活的医疗设备的总称。虽然已经有了原始机器,但这些机器并不是为了从头到尾地培养婴儿而设计的。相反,人工子宫是为了拯救那些即将分娩的早产儿的。这些系统能够复制胎盘和脐带的功能,支持早产儿继续妊娠,而不是将他们置于高死亡率和发病率的产前紧急护理。但一些研究人员认为,这些胎盘模拟物不仅可以用来让胎儿存活足够长的时间,让他们的肺完成发育,还可以在整个人工妊娠过程中滋养受精卵。

How does it work?

人造子宫是怎样工作的呢?

In March of 2021, Israeli scientists released information on their recent success growing mouse embryos in artificial wombs for upwards of twelve days, about half of the animal’s natural gestation period. The researchers did this by adding blood serum from human umbilical cords, “agitating” the cells in jars, and then pumping a pressurized oxygen mixture into the ectogestation machine, keeping the embryos oxygenated. According to Jacob Hanna, the leader of the team, the subjects only died because they’d grown so large that oxygen couldn’t efficiently diffuse through them without the natural blood system a placenta provides, but before then, they were perfectly healthy— they even had beating hearts and well-formed limbs.

2021年3月,以色列科学家发布了他们最近成功在人造子宫当中培育老鼠胚胎的信息,这一过程持续了12天以上,约为动物自然妊娠期的一半。研究人员通过加入人类脐带的血清,在罐子里“搅动”细胞,然后将加压的氧气混合物泵入体外合成机器,保持胚胎的充氧状态。据研究小组的负责人雅各布·汉纳说,试验胚胎之所以死亡,是因为他们长得太大了,没有胎盘提供的天然血液系统,氧气无法有效地在他们体内扩散,但在那之前,他们非常健康——他们甚至有跳动的心脏和形状良好的四肢。

In the original study they published, Hanna and his team discussed a number of other experiments involving toxins, dyes, and viruses; prior to now, the earliest stages of an embryo were incredibly difficult to study, but now the team has access to a resource that allows them to monitor development and the effects of certain additives on embryo health. Hanna believes that other scientists will want to use this technology, too, probably to extend the life of stem cells coaxed to behave similarly to early-stage embryos called blastoids. Hanna believes this research will be invaluable to learning more about embryological development, and some of his colleagues see even more applications. Bioethicist William Hurlbut, for example, believes this technology could be used to obtain primitive organs from first-trimester embryos for use in transplant medicine.

他们发表的研究报告中,汉纳和他的团队讨论了一系列涉及毒素、染料和病毒的其他实验;在此之前,研究胚胎的早期发育是非常困难的,但现在该团队获得了一种设备,使他们能够监控胚胎发育和某些添加剂对胚胎健康的影响。汉纳相信,其他科学家也想使用这项技术,其目的很可能是为了延长干细胞的寿命,使其表现出类似于被称为囊胚的早期胚胎的生物活性。汉纳认为,这项研究对于了解胚胎发育的更多知识将是无价之宝,他的一些同事看到了该项技术在更多方面的应用。例如,生物伦理学家威廉·赫尔布特认为,这项技术可以用来从妊娠早期的胚胎中获取原始器官,用于移植医学。

But what about growing healthy babies to full term? As of now, the technology to turn a zygote into a breathing baby doesn’t exist, but it’s getting closer every year. Modern “biobag” technology, which is used to support premature babies until they’ve reached a safe stage of development, is capable of facilitating the exchange of amniotic fluids and nutrients, while cannulae pump oxygen into the subject’s bloodstream, which mimics normal placental function. In clinical trials, the artificial womb was able to stabilize circulation and blood pressure, continue healthy lung development, and prevent deadly infections by virtue of its closed system.

但是如何让健康的婴儿长到满月呢?到目前为止,把受精卵变成会呼吸的婴儿的技术还不存在,但每年有关研究成果都在向该目的靠近。现在的“生物袋”技术,用于支持早产儿直到他们达到安全的发育阶段,能够促进羊水和营养物质的交换,同时套管将氧气泵入受试者的血液,这模仿了正常的胎盘功能。在临床试验中,人工子宫凭借其封闭的系统,能够稳定循环和血压,继续健康的肺部发育,并防止致命的感染。

As our understanding of gestation, embryological health, and ectogenesis continue to evolve, so will our ability to artificially support younger and younger fetuses. By implementing Hanna’s embryo-growing technology, which he believes could be used to support a human embryo until the first trimester, alongside artificial wombs intended to save second and third trimester fetuses, it’s possible we may soon see babies fertilized, grown, and born all ex-utero.

随着我们对妊娠、胚胎健康和外生的理解不断发展,我们人工培养年龄越来越小的胎儿的能力也将不断增强。通过实施汉纳的胚胎生长技术,他相信这一技术可以在妊娠前三个月开始培养人类胚胎,同时还可以通过人工子宫来拯救妊娠中期和妊娠晚期的胎儿,我们可能很快就会看到婴儿受精、长大,并全部在子宫外出生。

Implementation

“人造子宫”计划的施行

There is no sole group or identity of people that would benefit from access to artificial wombs. As the technology expands, it will continue to save the lives of sick mothers and premature fetuses, as it is already used today. But it will also become popular among people who are unable to naturally conceive, the LGBTQ+ community, and, of course, laboratories working with animals. Growing babies ex-utero may help childless families circumvent the expensive and sometimes legally problematic or unethical surrogacy process, as well as same-sex couples who have been denied children due to homophobia pervasive in the adoption and foster systems of many states and countries. Transmasculine people taking testosterone and those taking hormonal birth control to combat chronic illnesses such as polycystic ovarian syndrome would no longer need to stop their treatments to carry babies to term. And even those individuals with no reason not to have a traditional, in-utero pregnancy except their own personal preference deserve the opportunity to have children and families.

没有一个特定的群体或群体会从人工子宫中受益。随着这项技术的扩展,它将继续拯救生病的母亲和早产胎儿的生命,就像它今天已经在使用的那样。但它也会在无法自然受孕的人群、LGBTQ+群体,当然还有与动物有关的实验室中流行。在子宫外养育婴儿可以帮助无子女家庭规避昂贵的、有时在法律上有问题或不道德的代孕过程,以及由于在许多州和国家的领养和寄养系统中普遍存在的同性恋恐惧症而被拒绝生育的同性夫妇。服用睾酮的跨性别男性患者,以及那些为了对抗多囊卵巢综合征等慢性疾病而采取激素节育的跨性别男性患者,将不再需要停止治疗来生育足月婴儿做准备。即使是那些没有理由不进行传统的子宫内妊娠的人,除了他们自己的个人偏好,也应该有机会生孩子和组建家庭。

So beyond our currently limited technology, what’s stopping us? In some countries, such an England, artificial wombs may be illegal on a technicality— abortion laws prevent pregnancies from being ended prematurely after twenty-four weeks, even if the fetus is not actually harmed, so pregnant people needing or wanting to finish their baby’s gestation ex-utero for any reason may find themselves unable to utilize the technology. Others may not even be able to start the process; in some countries and in many laboratory or medical facilities, the “14-day Rule” prohibits the ex-utero growth of human embryos beyond two weeks. In some places, this law has been dropped or is being reconsidered, but in others, it fully prevents the early usage of ectogestational technology. Finally, as with most new technologies, artificial wombs promise to be very expensive, and therefore exclusive only to the wealthy or elite. But, many technologies that start as unattainable eventually fall into the hands of the public, through private companies, government subsidies, and the perfection of its manufacturing. Regardless of its initial price tag, the release of a functioning ectogenesis machine for personal use would eventually revolutionize the lives and reproduction of the entire world.

除了我们目前有限的技术,还有什么在阻止我们呢?在一些国家,比如英国,人工子宫在技术上可能是非法的——堕胎法禁止怀孕24周后过早结束,即使胎儿实际上没有受到伤害,因此,无论出于何种原因,需要或希望在子宫外完成胎儿妊娠的孕妇可能会发现自己无法利用这项技术。其他人甚至可能无法启动这一过程;在一些国家和许多实验室或医疗设施中,” 14天规则”禁止人类胚胎在子宫外生长超过两周。在一些地方,这项法律已经被废除或正在重新考虑,但在另一些地方,它完全阻止了外部培养早期胚胎技术的使用。最后,和大多数新技术一样,人工子宫预计将非常昂贵,因此只有富人或精英才能使用。但是,许多一开始难以企及的技术最终通过私人公司、政府补贴和完善的制造技术落入了公众手中。不管最初的价格如何,这台功能齐全、供个人使用的体外再生机器的发布,最终将彻底改变整个世界的生活和生殖方式。

Social Justice Factors

社会正义的因素

To many feminists, the artificial womb represents the last threshold to women’s emancipation and freedom. Eliminating the heavy physical, emotional, and mental toll of pregnancy allows people with uteruses to freely pursue desires and activities outside of their reproductive role, as biological men do, and further separates them from the patriarchal ideals of the nuclear family and stay-at-home, caregiving mothers. In this way, ectogenesis tackles institutional sexism on both a physical and conceptual level, taking pregnancy from a specifically feminine “issue” and making it something to be shared equally between parents.

对许多女权主义者来说,人造子宫代表了女性解放和自由的最后一道门槛。消除了怀孕带来的沉重的身体、情感和精神负担,让有子宫的人可以自由地追求生殖角色之外的欲望和活动,就像生理上的男人一样,并进一步将他们与核心家庭和居家照顾母亲的父权理想区分开来。通过这种方式,外生殖在身体和观念层面上解决了制度上的性别歧视,将怀孕从一个特定的女性“问题”中剥离出来,使它成为父母之间平等分享的事物。

But it is for that very reason that other activists see artificial wombs as dangerous, unethical, and actively harmful to women. Australian sociologist Robyn Rowland argues that ectogenesis will make women obsolete by handing their innate power over to the control of men, leading to “The Death of the Female”, as she and other feminists called one of the conferences on the subject. Others worry about the babies themselves, speculating about the weak bond between a machine-grown child and its parents, or about the commodification of life once humans can be made on command, without the need for an intimate, internal pregnancy.

但正是因为这个原因,其他活动人士认为人工子宫是危险的、不道德的,而且对女性非常有害。澳大利亚社会学家罗宾·罗兰认为,通过将女性天生的权力移交给男性的控制,外生殖将使女性过时,导致“女性的死亡”,她和其他女权主义者将这一主题的会议之一称为“女性的死亡”。另一些人则担心婴儿本身,他们猜测机器养育的孩子与其父母之间的纽带很薄弱,或者担心一旦人类可以被指挥,而不需要亲密的内部怀孕,生活就会商品化。

Perhaps most contentiously of all, however, is the artificial womb’s effect on the abortion debate. Currently, many laws ban abortion after the fetus can be considered “viable”, but what does that mean in a world where a fetus at any stage of developemnt could potentially be saved by an ectogenesis machine? Should all people seeking to end a pregnancy be required to pay for an artificial womb before the child can be put up for adoption? Do parents have the right to terminate an artificial pregnancy, given that the fetus is not inside of anyone else’s body? These questions— and many more like them— have no easy answers, and while it’s impossible to deny that ectogenesis machines would help bring reproductive equality to the LGBTQ+ community and save the lives of endangered mothers and babies, its potential misuses also cannot be ignored, and will have to be faced as a society moving forward into the yet unknown future of artificial wombs.

然而,也许最具争议的是人造子宫对堕胎辩论的影响。目前,许多法律禁止在胎儿被认为“成形”后堕胎,但在一个胎儿在任何发育阶段都有可能被体外发育机器拯救的世界里,这意味着什么?所有想要终止妊娠的人都应该被要求在孩子被领养之前支付人工子宫的费用吗?如果胎儿不在他人体内,父母是否有权终止人工妊娠?这些问题——以及更多类似的问题——都没有简单的答案,虽然我们不可能否认体外发育机器将有助于为LGBTQ+社区带来生殖平等,拯救濒危母亲和婴儿的生命,但它潜在的误用也不能被忽视,在这个社会迈向人工子宫的未知未来时,我们将不得不面对这个问题。

Non-human Prospects

“非人类”的前景

But not all uses of the ectogenesis machine have to involve humans. A little-talked about but promisingly viable use of the artificial womb is its usage on and for animals. Ectogenesis is already more effective on animals than it is on humans, and could be used for more than just saving premature lambs, but instead for saving whole species. Many animals, for instance, refuse or struggle to breed in captivity for a variety of reasons, including age, pickiness, and short estrus cycles. Mechanical wombs eliminate some of the biological uncertainty of artificial insemination, especially for older animals who cannot support a pregnancy, and can be used to produce a greater number of young in a shorter time (useful in the case of elephants, rhinoceroses, and other very slowly reproducing species.) Conservationists also have the ability to monitor the embryos at a much closer level, allowing them to detect diseases or deformities early in the developmental process. More domestically, ectogenesis eliminates the need for inhumane “puppy mills”; with the artificial womb, breeders are able to create more of a rare or desirable dog, cat, and other sought-after pet species without keeping living, pregnant individuals in poor conditions. The exotic pet trade, in which many endangered or foriegn animals die in transit between locations, also becomes obsolete when licensed breeders can use artificial wombs to locally raise exotic animals.

但并不是所有的体外发育机器都需要人类参与。很少有人谈论人工子宫,但它在动物身上和动物身上的应用是有希望实现的。体外发育在动物身上已经比在人类身上更有效了,它不仅可以用来拯救早产的羔羊,还可以用来拯救整个物种。例如,许多动物由于年龄、挑剔配偶和发情周期短等各种原因而无法在圈养环境中繁殖。机械子宫消除了人工授精在生物学上的一些不确定性,特别是对于不能怀孕的老年动物,可以用来在较短的时间内生产更多的幼崽(在大象、犀牛和其他繁殖非常缓慢的物种的情况下有用)。自然资源保护主义者也有能力在更近的水平上监测胚胎,使他们能够在发育过程的早期发现疾病或畸形。在国内,体外发育消除了对不人道的“幼犬饲养场”的需要;有了人造子宫,饲养者就能创造出更多稀有或更具有观赏价值的狗、猫和其他受欢迎的宠物,而不必在恶劣的条件下饲养怀孕的个体。当有执照的饲养者可以用人工子宫在当地饲养外来动物时,许多濒危或外国动物在运输途中死亡的外来宠物贸易也会过时。

Regardless of whether or not ectogenesis machines are ever used to grow a human child from embryo to birth, artificial wombs are already in use, and will likely only increase in popularity in the coming years. For both humans and animals, external pregnancy is life-saving for parents and children, and may someday work towards equality and fight back against extinction. But overall, no matter how we use, regulate, or protest it, ectogenesis has arrived, and it is, in some form, here to stay.

无论体外发育机器是否曾经被用来将人类婴儿从胚胎培育到出生,人造子宫已经在使用,而且在未来几年只会越来越受欢迎。对人类和动物来说,体外妊娠是父母和孩子的生命联系纽带,可能有一天会朝着平等和对抗灭绝的方向努力。但总的来说,无论我们如何使用、规范或抗议它,体外发育的时代已经到来,而且它早已经以某种形式存在。

STARSET_Mirror

1 条评论