Dr. Stefan Khmil performs synthetic insemination on a affected person in his Clinic of Prof. Stefan Khmil in Ternopil, Ukraine, on July 12.
Yurko Dyachyshyn for NPR
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Yurko Dyachyshyn for NPR
LVIV, Ukraine — As an OB-GYN physician, Stefan Khmil has constructed a virtually 50-year profession on serving to girls in Ukraine have youngsters — an particularly necessary job in Ukraine, the nation with the bottom delivery price in all of Europe.
Nonetheless, the final 2 1/2 years have been a specific problem, as Russia’s full-scale invasion has upended all the things.
Khmil says not solely have medical doctors and sufferers been displaced due to the preventing, the battle has additionally put the basic constructing blocks to make life in danger.
“A lot of [the doctors] evacuated with sperm, eggs and tools,” Khmil, 68, tells NPR. “So we helped them … to reserve it and to not lose all the things.”
He introduced a few of these cryogenically frozen specimens to his two clinics in western Ukraine — one within the metropolis of Ternopil and one in Lviv — so sufferers may proceed their child-conceiving remedies, akin to in vitro fertilization.
Quickly, Khmil began pondering past what had already been harvested.
“I began serious about what we have to do to protect the organic materials from our navy, so we began providing to freeze the spermatozoa of males serving within the navy without cost,” he says.
Dr. Stefan Khmil communicates with medical personnel in his medical heart in Lviv, Ukraine, on July 12.
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A preventing probability
Dr. Khmil’s obstetrics clinic was the primary of many throughout the nation to make the transfer, saving Ukrainians hundreds of U.S. {dollars} on the process.
In March, President Volodymyr Zelenskyy signed a legislation permitting troopers to just do that — protect their reproductive cells without cost.
Khmil says that the fear isn’t nearly dying in fight. Components akin to stress, excessive climate and the usage of chemical compounds and ammunition on the battlefield can all have a unfavourable impact on sperm — even render a person infertile.
“We may give these males who’re preventing the chance to have youngsters after the conflict, throughout conflict, each time they need,” Khmil says.
His clinics additionally provide the harvesting and freezing of navy girls’s eggs for gratis. Since Russia’s full-scale invasion in February 2022, Khmil has helped over 400 households and over 60 youngsters be born.
Viktoriia Onyshchuk hopes to be a type of success tales.
The 34-year-old from the town of Kryvyi Rih, in central Ukraine, is a fight medic and drove hours from the entrance line to have her eggs harvested at Khmil’s Lviv clinic.
Viktoriia Onyshchuk is a affected person of Dr. Stefan Khmil’s.
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“I’ve been attempting to have youngsters since 2010,” she says.
Onyshchuk’s husband, Petro, who can be within the navy, froze his sperm a while in the past. But it surely’s taken months for her to seek out time to get away to have the operation, resulting from lengthy rotations on the entrance.
In preparation for the surgical procedure, Onyshchuk has been taking highly effective hormone drugs. The drugs have brought on her bloating, cramping and fatigue — all compounded by her job. However since a girl’s physique sometimes solely produces one egg per menstrual cycle; for a profitable egg harvesting operation they should get between six and eight, she says.
However Onyshchuk doesn’t thoughts. She says it’s a girl’s responsibility to provide delivery — particularly now.
“We don’t know what’s going to occur to our nation,” she says. “And when peacetime comes, anyone should rebuild it.”
Inhabitants woes predate conflict
As Ukrainians attempt to conceive of life after conflict, issues about who will likely be round to hold Ukraine into the long run grasp over the nation like a pall.
However Ukraine’s demographic disaster far predates 2022. It really started as quickly because the nation gained independence from the Soviet Union in 1991, when its inhabitants was estimated to be about 52 million.
At the moment, the United Nations says Ukraine’s inhabitants is a bit below 38 million — a drop by nearly 1 / 4 in simply 30 years.
Dr. Olga Medvediva performs an ultrasound on Yulia Bambolya at Clinic of Prof. Stefan Khmil, in Lviv, Ukraine, on July 12.
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Tymofii Brik, the rector of Kyiv Faculty of Economics, says the explanations are a “little little bit of all the things.” Even lengthy earlier than the Russian invasion, Ukrainian males had among the highest mortality charges in Europe, resulting from dangerous work and life, he says, solely dwelling to 65 years previous, on common. Additionally, a lot of the inhabitants has merely left for higher, higher-paying work and a safer life with a much less aggressive neighbor.
Brik says, in the meantime, Ukraine can be experiencing the identical downturn in delivery price as different trendy, industrialized nations.
“When you might have these sorts of societies, normally plans and concepts of your life additionally change,” he says. “In these societies, normally individuals don’t plan to have a number of children.”
Ukraine’s Well being Ministry says the nation’s delivery price has been dropping since 2013. In 2023, the ministry studies, a median of about 16,100 youngsters have been born each month. Earlier than the full-scale invasion, the quantity ranged from 21,000 to 23,000-per month.
Massimo Diana, the U.N. Inhabitants Fund consultant in Ukraine, says that the nation’s delivery charges have dropped under one youngster per lady. Demographers say that’s far decrease than “replacement stage fertility” — which says the common variety of youngsters born per lady must be about 2.1 to take care of the inhabitants stage. Any larger quantity would obtain inhabitants progress.
Dr. Stefan Khmil, seen by window, performs gynecological procedures for a affected person.
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Russia’s full-scale invasion has displaced some 14 million Ukrainians with rather less than halfnonetheless remaining outdoors of the nation, in response to the U.N. refugee company.
So when the conflict ends, Brik says, Ukraine should work onerous to make households really feel secure and safe sufficient to not solely have youngsters — however to have extra youngsters than earlier than.
Future Ukrainians
OBG-YN medical doctors throughout Ukraine are there to assist the households who say they can not look ahead to peace.
Svitlana Teleniuk and her husband, Bohdan Teleniuk, needed extra youngsters despite the fact that they already had two boys. However when the full-scale invasion began, he went off to conflict and so they by no means discovered the time.
“He was solely house for a few days,” says Teleniuk, who’s 48 and from Ternopil.
So that they turned to Dr. Khmil, who froze Bohdan’s sperm in January 2023. Twins Angelina and Artur have been born in February the next yr.
Dr. Stefan Khmil and his affected person Svitlana Teleniuk.
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However these infants won’t ever meet their father, as Teleniuk came upon she was pregnant simply days after going to his funeral. Bohdan died on the entrance traces.
“The boy is an absolute copy of my husband, an an identical copy,” she says, lovingly peering into Artur’s twinkling brown eyes, his chubby cheeks turning pink with smiles.
Like so many different Ukrainian girls, Teleniuk will increase the twins and her older son by herself now. She says she’s proud and needs to do it herself.
Khmil acknowledges that life in Ukraine will seemingly not be simple for these moms and their youngsters born throughout conflict. However he sees his work — serving to households have children — as a approach of doing his half to avoid wasting his nation.
“Russia is destroying the Ukrainian nation and killing Ukrainian individuals — we have now to reply,” he says.
Dr. Stefan Khmil holds 4-month-old Angelina, born from synthetic insemination, at his medical heart, in Ternopil, Ukraine, on July 12.
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Polina Lytvynova and Hanna Palamarenko contributed to this story from Lviv and Ternopil, Ukraine.
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