LVIV, Ukraine — Dr. Stefan Khmil, an OB-GYN with nearly five decades of experience, has dedicated his career to assisting women in Ukraine with childbirth—a crucial role in a country facing the lowest birth rate in Europe. The ongoing conflict following Russia’s full-scale invasion has intensified the challenges surrounding reproductive health and family planning.
In the wake of the invasion, Khmil notes that both healthcare professionals and patients have faced significant displacement, jeopardizing essential resources needed for conception. “Many doctors evacuated with sperm, eggs, and equipment,” Khmil, 68, explained to NPR. To mitigate these losses, he facilitated the transfer of cryogenically frozen specimens to his clinics in Lviv and Ternopil, ensuring continuity of services like in vitro fertilization (IVF).
Recognizing the need to extend support beyond traditional practices, Khmil began offering free sperm freezing for military personnel. This initiative not only alleviates financial burdens for soldiers but also addresses concerns over potential infertility due to the stresses of combat. “We can give these men who are fighting the opportunity to have children after the war, during war, whenever they want,” he remarked.
In March, President Volodymyr Zelenskyy enacted legislation allowing soldiers to preserve their reproductive cells at no cost. Khmil’s clinics are also extending these services to female soldiers, allowing them to harvest and freeze their eggs without charge. Since Russia’s invasion began in February 2022, Khmil has aided more than 400 families, resulting in over 60 live births.
Among those hoping for success is Viktoriia Onyshchuk, a 34-year-old combat medic from Kryvyi Rih. After a long journey from the front lines, she sought Khmil’s help to harvest her eggs. “I have been trying to have children since 2010,” she shared. Her husband, Petro, already froze his sperm, but scheduling the egg retrieval has been difficult due to the demands of their military service.
In preparation for the procedure, Onyshchuk has endured the side effects of hormone medications, including bloating and fatigue. “For a successful egg harvesting operation, we need between six and eight eggs, as a woman typically produces only one per cycle,” she explained. Despite these challenges, she remains committed, believing it is her duty to give birth, especially during wartime. “We don’t know what will happen to our country, and when peacetime comes, somebody will have to rebuild it,” she added.
Ukraine’s demographic crisis is a long-standing issue, exacerbated by the war. Since gaining independence from the Soviet Union in 1991, Ukraine’s population has plummeted from about 52 million to under 38 million today, according to United Nations estimates. Tymofii Brik, rector of the Kyiv School of Economics, attributes this decline to a combination of high male mortality rates, emigration for better opportunities, and a broader trend seen in many industrialized nations where families opt for fewer children.
The Ukrainian Health Ministry reports that birth rates have been declining since 2013. In 2023, approximately 16,100 births were recorded each month, a stark contrast to pre-war figures that ranged from 21,000 to 23,000 monthly. The UN Population Fund representative in Ukraine, Massimo Diana, highlights that the current birth rate is below the replacement level of 2.1 children per woman, necessary for population stability.
With nearly 14 million Ukrainians displaced by the conflict, addressing the declining birth rate will be essential once the war concludes. Brik emphasizes the importance of creating a safe environment to encourage families to grow.
OB-GYNs like Khmil continue to support families unwilling to postpone their dreams of parenthood amid the ongoing turmoil. Svitlana Teleniuk, 48, and her husband Bohdan initially sought Khmil’s services to expand their family despite already having two sons. Tragically, Bohdan was killed in combat shortly before the birth of their twins, Angelina and Artur, conceived using the sperm Khmil froze.
Teleniuk shared her pride in raising her children alone, stating, “I’m determined to do it myself.” Khmil acknowledges the daunting future these families face but views his work as a vital contribution to preserving the Ukrainian nation. “Russia is destroying the Ukrainian nation and killing Ukrainian people—we have to respond,” he asserted.
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