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 vital job in Ukraine, the nation with the bottom delivery charge in all of Europe.
Nevertheless, the final 2 1/2 years have been a selected problem, as Russia’s full-scale invasion has upended every part.
Khmil says not solely have docs and sufferers been displaced due to the combating, 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 put it aside and to not lose every part.”
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, resembling 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 spending a dime,” he says.
Dr. Stefan Khmil communicates with medical personnel in his medical heart in Lviv, Ukraine, on July 12.
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Yurko Dyachyshyn for NPR
A combating likelihood
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 regulation permitting troopers to do exactly that — protect their reproductive cells without spending a dime.
Khmil says that the concern isn’t nearly loss of life in fight. Components resembling 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 combating the chance to have youngsters after the struggle, throughout struggle, every time they need,” Khmil says.
His clinics additionally provide the harvesting and freezing of navy girls’s eggs for free of charge. 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 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 making an attempt to have youngsters since 2010,” she says.
Onyshchuk’s husband, Petro, who can also be within the navy, froze his sperm a while in the past. Nevertheless it’s taken months for her to search out time to get away to have the operation, as a consequence of lengthy rotations on the entrance.
In preparation for the surgical procedure, Onyshchuk has been taking highly effective hormone medicines. The tablets have precipitated her bloating, cramping and fatigue — all compounded by her job. However since a lady’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 lady’s responsibility to offer delivery — particularly now.
“We don’t know what is going to occur to our nation,” she says. “And when peacetime comes, someone should rebuild it.”
Inhabitants woes predate struggle
As Ukrainians attempt to conceive of life after struggle, issues about who will probably be round to hold Ukraine into the long run grasp over the nation like a pall.
However Ukraine’s demographic crisis 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.
In the present day, the United Nations says Ukraine’s inhabitants is a bit underneath 38 million — a drop by virtually 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 every part.” Even lengthy earlier than the Russian invasion, Ukrainian males had among the highest mortality charges in Europe, as a consequence of dangerous work and existence, he says, solely residing 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 also be experiencing the identical downturn in delivery charge as different fashionable, industrialized nations.
“When you may have these sorts of societies, often plans and concepts of your life additionally change,” he says. “In these societies, often folks don’t plan to have lots of youngsters.”
Ukraine’s Health Ministry says the nation’s delivery charge has been dropping since 2013. In 2023, the ministry stories, a mean 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 birth rates have dropped below one baby per lady. Demographers say that’s far decrease than “replacement level fertility” — which says the typical variety of youngsters born per lady must be about 2.1 to keep up the inhabitants degree. Any greater quantity would obtain inhabitants development.
Dr. Stefan Khmil, seen via 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 half nonetheless remaining outside of the nation, in accordance with the U.N. refugee company.
So when the struggle 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 docs throughout Ukraine are there to assist the households who say they can not look forward to peace.
Svitlana Teleniuk and her husband, Bohdan Teleniuk, needed extra youngsters though they already had two boys. However when the full-scale invasion began, he went off to struggle and so they by no means discovered the time.
“He was solely dwelling 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 discovered she was pregnant simply days after going to his funeral. Bohdan died on the entrance strains.
“The boy is an absolute copy of my husband, an similar 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 elevate the twins and her older son by herself now. She says she’s proud and desires to do it herself.
Khmil acknowledges that life in Ukraine will probably not be simple for these moms and their youngsters born throughout struggle. However he sees his work — serving to households have youngsters — as a approach of doing his half to save lots of his nation.
“Russia is destroying the Ukrainian nation and killing Ukrainian folks — we now have 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.
