is over 5,000 years old?

是超過5000年的歷史？

That's right, some of the first forms of birth control

沒錯，最早的一些避孕方式是這樣的

date back to around 3,000 BC,

可追溯到公元前3000年左右。

and while the condom has made some strides

雖然安全套已經取得了一些進展。

since the Bronze Age, men still don't have

自青銅器時代以來，男人們仍然沒有...

a much better option all these millennia later.

千年之後，一個更好的選擇。

Besides a vasectomy.

除了輸精管結紮術。

Especially compared to the pills,

尤其是和藥丸相比。

IUDs, and implants available to women today.

宮內節育器，和植入物提供給今天的女性。

So why don't we have birth control for men?

那為什麼我們不給男人做節育手術呢？

In 2002, researchers asked

2002年，研究人員問

more than 9,000 men across four continents

四大洲9,000多名男子。

whether they'd be willing to use contraception

她們是否願意採取避孕措施；

capable of preventing sperm production.

能夠防止精子的產生。

Over half said yes.

超過一半的人說是。

So the problem isn't lack of interest,

所以問題不在於缺乏興趣。

it's partly human biology.

這部分是人類的生物。

Women ovulate just one or two eggs each month.

女性每個月只排卵一到兩個卵子。

Men, on the other hand, produce sperm daily,

而男性則是每天都會產生精子。

and it's not just one or two.

而且不只是一兩個人。

There's literally hundreds of millions of sperm

這裡有數以億計的精子。

produced each day, so because there's so many

每天都在生產，所以因為有這麼多的。

sperm produced, actually, you can reduce your sperm number

精子的產生，實際上，你可以減少你的精子數量。

over 90% and still be completely fertile.

90%以上，還能完全生育。

Narrator: To reach infertility, a man's sperm count

旁白：男人的精子數量要達到不孕不育的程度

needs to be somewhere around 1 to 10 million

需要在100萬到1000萬之間

per milliliter, but getting there is near impossible,

每毫升，但要做到這一點幾乎是不可能的。

at least without side effects.

至少沒有副作用。

That's because sperm count is tied

那是因為精子的數量是與精子的數量相關的。

to the production of testosterone.

到睪丸酮的產生。

In the past, researchers tried decreasing testosterone

過去，研究人員嘗試降低睪丸激素

in an effort to decrease sperm count.

以期減少精子數量。

The problem is you don't have any libido,

問題是你沒有任何性慾。

you have very little testosterone to act on other tissues

你有非常少的睪丸激素作用於其他組織。

and so forth, and so the side effects were so dramatic

諸如此類，所以副作用是如此的戲劇性。

that it really wasn't ever

它真的不曾

going to be a contraceptive pill.

將會是一種避孕藥。

Narrator: Scientists also tried using different compounds

旁白：科學家還嘗試使用不同的化合物

that attack the cells that produce sperm.

攻擊產生精子的細胞。

But again, biology got in the way.

但是，生物學又礙於情面。

Germ cells, as they're called, developed inside

胚胎細胞，就像它們的名字一樣，在體內發育。

a fortress-like structure within the testes.

睪丸內的堡壘狀結構。

So literally, nothing can get through it.

所以從字面上看，什麼都過不去。

There's been a lot of small molecule studies

有很多小分子的研究

to try and actually attack the germ cell

嘗試並實際攻擊生殖細胞

to stop it from working.

來阻止它的工作。

Literally, I can think of 10 or 15 different compounds

從字面上看，我可以想到10或15種不同的化合物。

that actually have been developed to do that,

實際上已經開發出了這樣的功能。

but they don't work because of that barrier.

但因為這個障礙，他們沒有工作。

Narrator: But the complex male anatomy

旁白：但複雜的男性解剖結構

isn't the only problem. It's also funding or lack thereof.

並不是唯一的問題。也是資金或缺乏資金的問題。

In 2002, two big pharmaceutical companies

2002年，兩家大型製藥企業

took interest in male contraception, Schering and Organon.

對男性避孕藥、先靈和Organon感興趣。

And together they funded a large clinical trial

他們一起資助了一項大型臨床試驗

on a hormone-based contraceptive,

激素類避孕藥；

offering hope that a pill backed by Big Pharma

提供希望，由大藥廠支持的藥丸。

might be on the horizon.

可能是在地平線上。

Then these two companies became, as you know,

後來這兩家公司成了，你也知道。

acquired by bigger company, and then even bigger company,

被更大的公司收購，然後是更大的公司。

so now they are merged in huge companies,

所以現在他們被合併成了大公司。

and women's health is still a priority

婦女的健康仍然是一個優先事項

in many of the companies,

在許多公司。

but men's health became part

但男人的健康成為一部分

of the general matter of health.

的一般健康問題。

And therefore, the development of contraception

是以，避孕措施的發展

becomes a really very low priority.

變成了一個非常低的優先級。

Narrator: According to Dr. Wang,

旁白：據王醫生說

male contraception was also too risky

男性避孕的風險也太大了

for Big Pharma at the time.

為當時的大藥廠。

The long-term side effects were unknown.

長期的副作用尚不清楚。

Companies were concerned that women might not trust it,

公司擔心女性會不信任它。

and despite the survey results, it was unclear whether men

而儘管調查結果，但不清楚男子是否

would actually use a hormone-based contraception.

會真正使用激素類避孕藥。

Today, the limited funding comes mostly from

如今，有限的資金主要來自於

government agencies like the National Institutes of Health.

國家衛生研究院等政府機構。

But there are in fact some promising lines of research.

但事實上，有一些有前景的研究方向。

Dr. Wang is working on a gel that can lower testosterone

王博士正在研究一種可以降低睪丸激素的凝膠。

where it matters, in the testes where sperm is produced,

睪丸是產生精子的地方。

while keeping testosterone levels normal elsewhere.

同時保持其他地方的睪酮水準正常。

That means low sperm count and, more importantly,

這意味著精子數量少，更重要的是。

no major side effects.

無大的副作用。

We have preliminary studies to show

我們有初步研究表明

that if we give the gel and if the man applies the gel,

如果我們給凝膠，如果該男子應用凝膠。

90% of the men will reach the level that you talk about,

90%的男人都會達到你所說的水準。

1 million per mil.

每英里100萬。

And Skinner is pursuing a new approach,

而斯金納正在追求一種新的方法。

shutting down Sertoli cells,

關閉Sertoli細胞。

which are a part of that impenetrable barrier

屬於不可逾越的障礙的一部分

that houses germ cells.

那裡面有生殖細胞。

So if you shut down the Sertoli cell,

所以如果你關閉了Sertoli細胞，

then you shut down the sperm production.

那麼你就會關閉精子的生產。

Narrator: But perhaps most promising

旁白：但也許是最有希望的

is a sort of reversible vasectomy that's in the works.

是一種可逆的輸精管結紮術，正在進行中。

So they have this ability to inject this gel

所以他們有這個能力注射這種凝膠

into what's called the vas deferens,

進入所謂的輸精管。

and it makes this plug, so then essentially

它使這個插件，所以，然後基本上

it does the same thing, but you're not cutting it.

它做了同樣的事情，但你沒有削減它。

Then believe it or not, you can actually

那麼不管你信不信，其實你可以

inject this chemical mixture, which will dissolve the plug,

注入這種化學混合物，它將溶解塞子。

and so then you can get your fertility back.

這樣就可以恢復生育能力了。

Narrator: But as promising as these approaches may be,

旁白：但是，儘管這些方法可能很有前途，

they're still years, if not decades, out, Skinner says.

斯金納說，他們還需要幾年甚至幾十年的時間。

And without more funding, some of them

如果沒有更多的資金，他們中的一些人

may never hit the market.

可能永遠不會上市。

So at least for now, men are left with few options.

所以至少現在，男人的選擇不多。

Irreversible vasectomies, pulling out ,

不可逆的輸精管切除術，拔出 。

and that slightly updated Bronze Age invention.

以及那略微更新的青銅時代發明。