28 130. The complete prohibition of a means that could allow victims to reach a situation of equality, exacerbates the differences between them and persons and/or fertile couples, and even couples and/or infertile persons, that had access to other means to procreate biologically. It serves to perpetuate a distinction that should only be deemed compatible with the American Convention if it is reasonable and objective. To evaluate distinctions of this kind, the Commission, the Court and other international organizations and courts have applied criteria similar to those used when analyzing restrictions on human rights. Thus, a distinction will be reasonable if it pursues a legitimate aim, is suitable for achieving that aim, there are no other less restrictive alternatives and is proportionate. The Commission has already analyzed these criteria in the section on the right to a private and family life and the right to found a family. Its conclusion was that the ban on in vitro fertilization was unnecessary and, therefore, incompatible with the provisions of Article 24 of the Convention. 131. As for the second point, the Commission observes that the technique of in vitro fertilization is a procedure that more directly concerns the woman’s treatment and body and hence women bear the brunt of the impact of the Costa Rican Constitutional Chamber’s decision. The purpose of in vitro fertilization is to enable the embryo to become implanted in the woman’s uterus; in other words, the procedure is in large part centered on what a woman wants and decides to do with her own body. These are questions that, in principle, are up to the woman, in consultation with her physician, and to the couple as well. It is in this sense that the absolute ban on the procedure will take a heavier toll on women. In effect, while infertility is a condition that can affect both men and women, the use of assisted reproductive technologies places greater demands on the woman’s body. Therefore, the prohibition of in vitro fertilization has a direct effect on women’s free will with regard to their bodies. 132. Article 12(1) of the CEDAW reads as follows: States Parties shall take all appropriate measures to eliminate discrimination against women in the field of health care in order to ensure, on a basis of equality of men and women, access to health care services, including those related to family planning. 133. The CEDAW Committee has written that “the obligation to respect rights requires States parties to refrain from obstructing action taken by women in pursuit of their health goals.” 109 Hence, the ban on in vitro fertilization has very serious consequences for women and denies them access to the ever-evolving benefits of scientific progress in this area. 134. Given the above considerations, the Commission concludes that the Costa Rican State violated the right to equality and the principle of non-discrimination, recognized in articles 24 and 1(1) of the American Convention, in relation to the obligations undertaken in Article 2 of that instrument, to the detriment of Gretel Artavia Murillo, Miguel Mejía Carballo, Andrea Bianchi Bruno, German Alberto Moreno Valencia, Ana Cristina Castillo León, Enrique Acuña Cartín, Ileana Henchos Bolaños, Miguel Antonio Yamuni Zeledón, Claudia María Carro Maklouf, Víctor Hugo Sanabria León, Karen Espinoza Vindas, Héctor Jiménez Acuña, Maria del Socorro Calderón P., Joaquina Arroyo Fonseca, Geovanni Antonio Vega, Carlos E. Vargas Solórzano, Julieta González Ledezma and Oriester Rojas Carranza. V. 109 CONCLUSIONS United Nations. Committee on the Elimination of Discrimination against Women, General Recommendation 24, Women and Health.

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