11 49. Therefore, based on the information in the case file, the ban on in vitro fertilization in Costa Rica following the Constitutional Chamber’s March 15, 2000 ruling is still in effect. 50. This ban has forced some of the alleged victims to seek that treatment abroad. A case in point is that of Andrea Bianchi Bruno, who told the Commission that she had spent US$ 30,000 for an in vitro fertilization treatment in Colombia, which in Costa Rica would have cost US$3,000 had it been permissible there. 25 She also said she had to resign from her job, as she worked in the medical field and her job did not allow her to take the leave she would need to undergo the procedure. 26 In other cases, like that of the alleged victim Ileana Henchoz Bolaños, the prohibition of in vitro fertilization has meant that because of her age, it is no longer biologically feasible for the in vitro fertilization procedure to be practiced on her. 27 B. Prior definitions and preliminary questions 51. The Commission will now proceed to clarify certain questions related to infertility, the assisted reproductive techniques and in vitro fertilization. 1. Infertility in the international context 52. A number of organizations recognize that infertility is a source of physical and psychological suffering for the couples, particularly the women, and can even strain the couple’s relationship. 28 The most current clinical definition issued by the International Committee for Monitoring Assisted Reproductive Technology and the World Health Organization is that infertility is 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.” 29 53. The most common causes of infertility are low sperm or egg production, or damage to or abnormalities of the female reproductive system that prevent the sperm and egg from uniting. 30 A small percentage of couples, no more than 5%, are infertile for unknown and therefore untreatable reasons. A higher incidence of infertility is referred to as acquired infertility, which generally indicates that there are community factors that can cause new infertile couples. The main causes of acquired infertility are pelvic infections caused by sexually transmitted diseases (like 25 26 Hearing on the case before the IACHR, held on October 28, 2008. Hearing on the case before the IACHR, held on October 28, 2008. 27 First Chamber of the Supreme Court of Justice, judgment of May 7, 2009, Case 08-000178-1027-CA, Res. 000465-F-S1-2009, which the State forwarded via a communication dated January 22, 2010. 28 World Health Organization, Current Practices and Controversies in Assisted Reproduction, Report of a meeting on “Medical, Ethical and Social Aspects of Assisted Reproduction” held at WHO Headquarters in Geneva, Switzerland 17–21 September 2001, See: Foreword; Current Challenges in Assisted Reproduction, Mahmoud F. Fathalla; Infertility and social suffering: the case of ART in developing countries, Abdallah S. Daar, Zara Merali. 29 The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO), Revised Glossary on ART Terminology, 2009, published in Human Reproduction, Vol.24, No.11 pp. 2683–2687, 2009; see also British Fertility Society, available online at: http://www.britishfertilitysociety.org.uk/public/factsheets/keyfacts.html. 30 Amicus curiae brief presented by Yale Law School’s Allard K. Lowenstein International Human Rights Law Clinic, September 26, 2005, p. 3.