whoever established this law or practice was unaware of these practical consequences and, in that case, the intention to discriminate is not essential, and an inversion of the burden of proof is in order. In this regard, the Committee on the Rights of Persons with Disabilities has indicated that “a law that is applied impartially may have a discriminatory effect if it does not take into consideration the particular circumstances of the persons to which it is applied.” 448 For its part, the European Court of Human Rights has also developed the concept of indirect indiscrimination establishing that, when a general policy or measure has an effect that is disproportionately prejudicial to a particular group, this may be considered discriminatory even if it was not specifically addressed at that group. 449 287. The Court considers that the concept of disproportionate impact is related to that of indirect discrimination, and will therefore analyze whether there was a disproportionate impact in relation to disability, gender and financial situation. D.2.a) Indirect discrimination in relation to the condition of disability 288. The Court takes note that the World Health Organization (hereinafter “WHO”) has defined infertility as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse” (supra para. 62). According to expert witness Zegers-Hochschild, “infertility is a disease that has numerous effects on the physical and psychological health of the individual, as well as social consequences, which include unstable marriages, anxiety, depression, social isolation and loss of social status, loss of gender identity, ostracism and abuse […]. [I]t results in anguish, depression and isolation and weakens the family ties.” Expert witness Garza testified that “[i]t is more exact to consider infertility as a symptom of an underlying disease. The diseases that cause infertility have a two-fold effect […] preventing fertility from functioning, but also causing, in both the short- and the long-term, health problems for men and women.” Similarly, the World Medical Association has recognized that assisted conception “differs from the treatment of illness in that the inability to become a parent without medical intervention is not always regarded as an illness. While it may have profound psychosocial, and thus medical, consequences, it is not in itself life limiting. It is, however, a significant cause of major psychological illness and its treatment is clearly medical.” 450 289. The right of persons with disabilities to have access to the necessary techniques to resolve reproductive health problems can be inferred from Article 25 of the Convention on the Rights of Persons with Disabilities (hereinafter “CRPD”). 451 While expert witness Caruso 448 Cf. Committee on the Rights of Persons with Disabilities, Communication No. 3/2011, Case of H. M. v. Sweden, CRPD/C/7/D/3/2011, 19 April 2012, para. 8.3. 449 ECHR, Case of Hoogendijk v. The Netherlands, No. 58641/00, First Section, 2005; ECHR, Grand Chamber, D. H. et al. v. Czech Republic, No. 57325/00, 13 November 2007, para. 175, and ECHR, Case of Hugh Jordan v. United Kingdom, No. 24746/94, 4 May 2001, para. 154. 450 The World Medical Association, Statement on Assisted Reproductive Technologies, adopted by the WMA General Assembly, Pilanesberg, South Africa, October 2006, Available at: http://www.wma.net/e/policy/r3.htm, para 6. Statement cited in the Inter-American Commission’s merits report (merits report, volume I, footnote 36) and in the answering brief (merits report, volume III, folio 1086). 451 Article 25(1) establishes: Health: States Parties recognize that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability. States Parties shall take all appropriate measures to ensure access for persons with disabilities to health services that are gender-sensitive, including health-related rehabilitation. In particular, States Parties shall: (a) Provide persons with disabilities with the same range, quality and standard of free or affordable health care and programmes as provided to other persons, including in the area of sexual and reproductive health and population-based public health programmes.”