indicated that the “problems associated with in vitro fertilization are the high death rate of
the human embryos that are transferred to the uterine cavity by artificial means.” It cited
some phenomena “to explain some of the problems that may be involved in the high
inefficiency of IVF”: (i) the state of development of the ovules used: the induction of multiovulation, which is usually carried out in order to practice IVF, is carried out using
gonadotropins, but the state of development of the ovules obtained by this procedure is
often inadequate”; (ii) “since the procedure of the selection of normal and mature
spermatozoids that occurs naturally does not occur in [IVF], conception occurs with defective
spermatozoids in many cases”; (iii) “the percentage of embryos whose development ceases
between the stages of zygote and blastocyst is higher when their development is generated
in vitro rather than in vivo […]. The embryo that is generated has a better intrinsic viability
than the one created in vitro; in other words, the embryos created in the laboratory are less
healthy,” and (iv) “it has been demonstrated that the embryo sends signals to prepare the
endometrium for the implantation, which could provide a partial explanation why the rate of
implantation is so low in the case of IVF, since the pre-implanted embryo is not present in
the woman’s body.” Thus the State argued that “[t]he only solution is to prohibit the
technique, because this is the only way to guarantee the life of the embryo as of fertilization”
and that, therefore, “it could not be obliged to weigh the rights involved differently in this
case, because there is no way to do so.” In addition, the State asserted that “the
Constitutional Chamber’s judgment […] is not omissive as regards weighing the factors
involved, [because] it considered that the constitutional prohibition of the in vitro technique
was necessary to protect the right to life of the embryo.” It added that “[t]he fact that, in
Costa Rica, the Constitutional Chamber has endorsed the existence of therapeutic abortion
[…] is not contrary to the prohibition of” IVF, because, in that case, “the weighing up process
must be made between the right to life of the mother and the right to life of the embryo.”
271. Finally, regarding the alleged indirect discrimination, the State indicated that
“[i]nfertility is a natural condition that is not induced by the State.” In addition, it argued
that “there is no consensus that infertility is, per se, a disease” or that it can “be considered
a disability.” In this regard, the State argued that “[a]ssisted conception is different from the
treatment of an illness”; IVF does not “cure” infertility, because “it does not constitute a
treatment to change the situation that causes a couple or an individual to be infertile, but
constitutes a means to substitute the natural fertilization process.” In addition, it argued that
the prohibition of IVF “is not designed to establish discrimination against those who are
unable to have children naturally, and especially against women,” because the prohibition
“was addressed at everyone irrespective of their condition: single, married, women or men,
fertile or infertile.” Consequently, it argued the ban on IVF has not had a “special intensity”
in relation to women, thus it does not discriminate indirectly, because “it does not originate
only from problems suffered by women.”
Considerations of the Court
272. The Court has indicated that the decision to have biological children using assisted
reproduction techniques forms part of the sphere of the right to personal integrity and to
private and family life. In addition, the way in which this decision is arrived at is part of the
autonomy and identity of a person, in both the individual dimension and as part of a couple.
The Court will now analyze the State’s interference in relation to the exercise of these
rights.
273. In this regard, in its case law, the Court has established that a right may be
restricted by the States provided that the inferences are not abusive or arbitrary;