As Ukraine start fee plunges, a health care provider performs IVF, different fertility remedies : 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 essential job in Ukraine, the nation with the bottom start fee in all of Europe.

Nevertheless, the final 2 1/2 years have been a selected 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 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 gear,” 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 might proceed their child-conceiving remedies, reminiscent of in vitro fertilization.

Quickly, Khmil began considering past what had already been harvested.

“I began desirous about what we have to do to protect the organic materials from our army, so we began providing to freeze the spermatozoa of males serving within the army without cost,” he says.

A combating 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 concern isn’t nearly loss of life in fight. Components reminiscent of stress, excessive climate and the usage of chemical compounds and ammunition on the battlefield can all have a unfavorable impact on sperm — even render a person infertile.

“We may give these males who’re combating the chance to have youngsters after the warfare, throughout warfare, each time they need,” Khmil says.

His clinics additionally provide the harvesting and freezing of army 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 kind 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.

“I’ve been attempting to have youngsters since 2010,” she says.

Onyshchuk’s husband, Petro, who can be within the army, 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, on account of lengthy rotations on the entrance.

In preparation for the surgical procedure, Onyshchuk has been taking highly effective hormone medicines. The tablets have brought about her bloating, cramping and fatigue — all compounded by her job. However since a girl’s physique usually 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 start — particularly now.

“We don’t know what is going to occur to our nation,” she says. “And when peacetime comes, anyone must rebuild it.”

Inhabitants woes predate warfare

As Ukrainians attempt to conceive of life after warfare, considerations about who can be round to hold Ukraine into the longer term 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 somewhat beneath 38 million — a drop by virtually 1 / 4 in simply 30 years.

Tymofii Brik, the rector of Kyiv College of Economics, says the explanations are a “little little bit of all the things.” Even lengthy earlier than the Russian invasion, Ukrainian males had a number of the highest mortality charges in Europe, on account of dangerous work and life, 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 be experiencing the identical downturn in start fee as different fashionable, 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 folks don’t plan to have a whole lot of youngsters.”

Ukraine’s Well being Ministry says the nation’s start fee has been dropping since 2013. In 2023, the ministry studies, a median of about 16,100 youngsters had 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 start charges have dropped under one youngster per lady. Demographers say that’s far decrease than “alternative 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 greater quantity would obtain inhabitants progress.

Russia’s full-scale invasion has displaced some 14 million Ukrainians with rather less than half nonetheless remaining outdoors of the nation, in line with the U.N. refugee company.

So when the warfare ends, Brik says, Ukraine must work laborious 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 watch for peace.

Svitlana Teleniuk and her husband, Bohdan Teleniuk, needed extra youngsters regardless that they already had two boys. However when the full-scale invasion began, he went off to warfare they usually 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 had been born in February the next 12 months.

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 traces.

“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 purple 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 needs to do it herself.

Khmil acknowledges that life in Ukraine will doubtless not be straightforward for these moms and their youngsters born throughout warfare. 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.

Polina Lytvynova and Hanna Palamarenko contributed to this story from Lviv and Ternopil, Ukraine.