264). To the contrary, the Court observes that expert witness Zegers-Hochschild
emphasized that “[t]he process that generates human life includes embryonic death as part
of a natural and necessary process. Of every 10 embryos spontaneously generated in the
human species, no more than 2 to 3 are able to survive natural selection and be born as a
person. The remaining 7 or 8 embryos die in the female genital tract, generally without the
parents’ knowledge.” 484
311. Bearing in mind the above, the Court finds it disproportionate to aspire to an
absolute protection of the embryo in relation to a risk that is common and even inherent in
processes where the IVF technique has not been used. The Court shares the opinion of
expert witness Zegers-Hochschild that “[f]rom a biomedical perspective, it is essential to
differentiate the meaning of protecting the right to life from the meaning of ensuring the
right to life of cellular structures that are regulated by mathematics and biology, which
transcend any social or legal regulation. The institutions responsible for [assisted
reproduction techniques] should provide the cellular structures (gametes and embryos) with
the optimum conditions offered by medical and scientific knowledge so that potentiality of
being a person can be expressed at birth […].” The Court reiterates that, precisely, one of
the purposes of IVF is to contribute to the creation of life (supra para. 66).
312. The Court also observes that Costa Rica permits artificial insemination techniques
even though the use of such techniques does not guarantee that each egg will result in a
pregnancy, thus entailing the possible loss of embryos. The decision to become pregnant,
even by natural fertilization may also be preceded by a conscious act that takes measures to
increase the probability of the egg being fertilized. According to the State’s final arguments:
Artificial insemination is one of the treatments offered by the Costa Rican Social Security Institute. At
times, as a result of hormone treatment and as an individual response, patients may present greater
stimulation of the ovaries than expected; consequently, when this follicle production is 6 or more in
both ovaries, the cycle is annulled. 485
313. In brief, embryonic loss exists in both natural pregnancy and in techniques such as
artificial insemination. The Court observes that scientific debate exists about the differences
between the type of embryonic losses that occur in these processes and their reasons. But
the analysis made above allows the Court to conclude that, taking into account the
embryonic losses that occur in a natural pregnancy and in other reproduction techniques
484
Opinion provided by expert witness Zegers-Hochschild at the public hearing held in this case. He explained
that “[t]he results of ART vary significantly according to the age of the woman and the number of embryos
transferred and, in some cases, to the severity of the condition that gave rise to the disease. […] The proportion of
chromosomally abnormal eggs is very high in the human species. This means that a large percentage of fertilized
eggs do not advance in embryonic development and a high proportion of transferred embryos do not implant and
do not result in a pregnancy. […] The analysis of these data reveals that […] the technique of IVF or
[intracytoplasmic sperm injection] ICSI does not generate embryos of a lesser biological value than those
generated spontaneously in a woman’s body, [and] that embryonic death as part of a medical treatment, does not
occur as a direct result of the technique, but as the result of the poor quality of the oocyte and embryo that are
natural to both women and men. In women with healthy eggs, the possibility of conceiving from one embryo
generated in vitro is no different from one generated spontaneously. In itself, the IVF/ICSI does not affect the
possibility of implantation and conception. Hence, the lower rates of pregnancy in women with IVF are not due to
the interference of the technique; but rather they are mainly the result of the underlying disease that determines a
lower reproductive performance. […] The process that creates human life includes embryonic death as part of a
natural and necessary process. Of every 10 embryos generated spontaneously in the human species, no more than
2 to 3 are able to survive natural selection and to be born as a person. The remaining 7 or 8 embryos die in the
female genital tract, generally without the parent’s knowledge. The question that must be answered is whether the
ART, such as IVF or ICSI contribute to the death of embryos because they have been fertilized outside a woman’s
body and then transferred to her. The answer to this question is that neither IVF or ICSI affect the possibility of
survival of embryos and, evidently, do not kill them.”
485
The State’s final written arguments (merits report, volume XI , folio 5314).