JBRA Assist. Reprod. 2011;15(1):14-14
EDITORIAL
doi: 10.5935/1518-0557.2011.15.1.01
RED Regional Director
The Costa Rican Constitutional Court prohibited embryo cryopreservation first and later IVF in 2001. It noted that IVF leads to “the lost of human lives.” However, this also happens to many embryos that are formed during sexual acts, not least because they have chromosomal abnormalities. For 10 years the scientific community has been trying to explain this to the Costa Rican government-without success. Interestingly, researchers in the Costa Rican case can identify only one other country, Libya, that outlaws IVF.
In 2001, the Instituto Costarricense de Infertilidad and several infertile patients sued the Costa Rican government at the Inter-American Commission of Human Rights. Recently, the commission considers that Costa Rica violates human rigths and recommended that the government approve a law authorizing IVF and that it should provide compensation to all the couples in the suit. The government seems keen to consent to this ruling.
However, a small but influential religious group is opposing this move. As a result, the new draft law we now have contradicts both human rights and the most basic scientific evidence.
For instance, the new bill proposes that all fertilized eggs created during the IVF process be transferred directly to the uterus. The guidelines and laws in every other country where IVF is regulated instead recommend the transfer of a single embryo, or on rare occasions, two - but never all of them. Costa Rica is moving backwards.
Fertility associations around the world consider transferring all the fertilized eggs to the uterus to be harmful because it can lead to multiple pregnancies and therefore increase subsequent complications, which include premature birth, maternal and child death, cerebral palsy, chronic lung problems, and neurological problems.
In addition, the new law forbids cryopreservation, despite the fact that the latest method - vitrification - results in the survival of all the preserved pre-embryos. So why ban it?
The United Nations rightly considers that freedoms related to expression and belief, and a right to health (broadly defined), and the right to avail of scientific advances are all integral to the human experience. The World Health Organization defines infertility as a disease. Scientists at Harvard University have determined that most people consider having children to be an essential part of their lives. An inability to conceive can lead to severe depression.
Governments have the duty of promote health and the duty to prevent discrimination against people with disabilities. Costa Rica has a wonderful opportunity to show the world that it now understands that true leadership means embracing justice, compassion and a respect for scientific evidence. The Red Latinoamericana de Reproducción Asistida hopes that the government of Costa Rica does the right thing, being a country that respects and promotes human rights.
The Red Latinoamericana de Reproducción Asistida agrees with the recommendation by the Inter-American Commission of Human Rights. In solidarity with specialists and patients in the region, we offer our support to Costa Rica as they seek to resolve the current impasse. We are happy to provide more information about the process, about the latest scientific evidence, international standards and best practices round the world. IVF is a safe and effective medical procedure that engenders wellbeing in our patients. We urge members of the National Costa Rican Assembly to do the right thing for those whom they represent - which includes many thousands of women and men who want nothing more than to bring new life into the world.
Maria Teresa Urbina
RED Regional Director