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扰乱生物钟:生育益处、卵子冷冻与积极的生育管理。

Disrupting the biological clock: Fertility benefits, egg freezing and proactive fertility management.

作者信息

van de Wiel Lucy

机构信息

King's College London, London, UK.

出版信息

Reprod Biomed Soc Online. 2021 Dec 10;14:239-250. doi: 10.1016/j.rbms.2021.11.004. eCollection 2022 Mar.

Abstract

In the last decade, the in-vitro fertilization (IVF) sector has witnessed a shift from so-called 'reactive IVF' to a new model of proactive fertility care. Whereas IVF was traditionally developed to treat people who found they were unable to conceive, the indication for IVF has broadened significantly to include a much wider group of potential patients through a new focus on proactive treatment of future (in)fertilities. This shift combines a number of new trends pertaining to preservation, prediction, private equity and platformization, all of which have gained influence in contemporary assisted reproduction. This article focuses on the emergence of company-sponsored fertility benefits, which combines each of these trends. Whereas fertility benefits - especially egg freezing insurance - have primarily been discussed in terms of women's empowerment or disenfranchisement, this article instead calls attention to the discursive, clinical and infrastructural shifts in contemporary assisted reproduction that have emerged with the rising popularity of these benefits. The analysis addresses these underdiscussed aspects of fertility benefits by focusing on the dynamics of demand; the shifts in the rationalization of intensified treatment pathways in the face of new reimbursement practices; and the online, platform-based infrastructures that are built to provide these treatments. In doing so, it analyses how this remaking of fertility towards an ethos of proactive fertility management reflects broader capitalist tailwinds.

摘要

在过去十年中,体外受精(IVF)领域见证了从所谓的“反应性IVF”向积极生育护理新模式的转变。传统上,IVF是为治疗那些发现自己无法受孕的人而开发的,但通过对未来(不)孕症的积极治疗的新关注,IVF的适应症已显著扩大,涵盖了更广泛的潜在患者群体。这种转变结合了与保存、预测、私募股权和平台化相关的一些新趋势,所有这些趋势在当代辅助生殖中都产生了影响。本文重点关注公司赞助的生育福利的出现,它结合了上述每一种趋势。虽然生育福利——尤其是卵子冷冻保险——主要是从女性赋权或被剥夺权利的角度进行讨论的,但本文转而关注随着这些福利日益普及而在当代辅助生殖中出现的话语、临床和基础设施方面的转变。该分析通过关注需求动态、面对新的报销做法时强化治疗途径合理化的转变以及为提供这些治疗而建立的基于平台的在线基础设施,来探讨生育福利这些较少被讨论的方面。在此过程中,它分析了这种将生育重塑为积极生育管理理念的做法如何反映了更广泛的资本主义顺风趋势。

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