'We're Trying To Save Not Only Our Soldiers—We're Trying To Save Our Future Citizens'
In the week following Russia’s invasion of Ukraine on February 24, 2022, traffic stood at a standstill for miles on the roads leading out of Ukraine. Citizens were fleeing the danger of airstrikes and military gunfire in the country—thousands of headlights were constantly pointed toward the borders. Very few cars were headed in the opposite direction during that time.
Uliana Dorofeyeva, MD, ob-gyn, was in one of them. She was on a mission from Bratislava, the capital of Ukrainian neighbor, Slovakia, back into the heart of her home country, to retrieve the frozen embryos, eggs, and sperm she was responsible for as the medical director of OVOGENE Egg Donor Bank in Lviv, Ukraine.
“The customs officers asked why we wanted to go in there. Like, you’re already here, safe,” says Dr. Dorofeyeva. This was just one of five trips she made back and forth over several days to bring this cryogenically-frozen reproductive material from OVOGENE’s Lviv facility to their Bratislava location, safely stored in six large transportation tanks, each filled with liquid nitrogen and about 1,000 samples of genetic material, in the back of her car.
“I was getting 24/7 emails and calls from clients asking when and where we were going to move their material,” she says. “On the first day, the lines going out of Ukraine were just crazy. I remember looking at my navigation, and a trip that would normally take hours was going to take several days if I waited in line. Luckily, because I was carrying genetic material, it was like a medical relocation, and I had documents that allowed me to use a special lane.”
Despite the frustrations of the traffic, when Dr. Dorofeyeva encountered completely empty highways on her last retrieval day, it was terrifying and apocalyptic. “It was really scary to go into Ukraine because there was nobody. There were alarms going off. On the radio there was an alert saying you need to go somewhere safe and telling you where to go if you’re driving on the road.”
The protection and transportation of frozen embryos, eggs, and sperm is a modern problem of war, and one that’s not often talked about, given that it may seem inconsequential compared to other tragedies. But for many couples and individuals, the ability to have children in the future is everything.
“Russian troops have killed not only our soldiers and civilians, they have killed future babies as embryos,” says Valery Zukin, MD, ob-gyn, director of the Nadiya Clinic in Kyiv, Ukraine, where he has stayed behind to watch over the reproductive material in his clinic. Several fertility clinics and reproductive donor banks have been destroyed in Eastern Ukraine, he says. “We’re trying to save not only our soldiers and our citizens—we are trying to save future citizens and future babies.”
Because of its popularity as a surrogacy destination (most all fertility preservation, IVF, and surrogacy services are less expensive in Ukraine than other parts of the world, including the U.S., and it’s one of only a few countries that allow surrogacy for foreigners), the country contains an inordinate number of frozen embryos. Ukraine houses genetic material from countless foreign couples and individuals (a multitude of Americans have their reproductive futures stored here), on top of the gametes and embryos of Ukrainian people looking to conceive. Many doctors and fertility clinic staff in Ukraine, like Dr. Dorofeyeva, believe it is their duty to make sure this material is kept safe.
That’s what led Dr. Zukin to remain in Kyiv when most of his staff fled the country. He’s currently watching over nearly 19,000 embryos (roughly 10 percent of which belong to foreigners) in his clinic, one of the largest in Ukraine, which offered services like IVF, egg donation, embryo banking, and artificial insemination before the latest Russian invasion.
“I had a patient call me from Israel, and she told me she had been in my clinic 12 years ago to freeze her eggs and couldn’t come back all that time. She was 36 then, and now she’s 48. She said, ‘It’s my last year to try to have a child, my last chance,’” says Dr. Zukin. “I feel it is impossible to destroy that material.”
Supply and delivery issues throughout Ukraine have made it difficult for Dr. Zukin to secure the liquid nitrogen to keep the embryos frozen—it needs to be replaced once every two weeks to keep reproductive material viable. A limited supply of liquid nitrogen led to the deterioration of countless embryos in the country in 2014, when the Russo-Ukrainian War first began. Thankfully, Dr. Zukin says, he hasn’t lost any genetic materials yet this time, but he knows other clinics haven’t been so lucky.
Getting the embryos out of Kyiv has also been a challenge, given that Nadiya Clinic has limited transportation canisters available, says Dr. Zukin. He’s only been able to move about 1,000 embryos to clinics further west or outside Ukraine. While it’s a risk to stay in one place, it’s equally as dangerous to leave the protection of bomb shelters and basements. “We are trying to stay safe but we also understand that this is impossible, with missiles and bombs,” says Dr. Zukin. “Nobody knows when it will be next. And with the landing of the missiles, maybe it will be in the clinic, in your place. It is impossible to predict.”
It’s also difficult, legally, to transfer genetic material across borders. In early March, the European Society of Human Reproduction and Embryology set out to address these legal barriers, granting paperwork to ensure frozen gametes could be safely transported across borders, but this action hasn’t been helpful on a practical level, says Dr. Dorofeyeva.
“The paper is not helping on the border, you cannot show it to the customs officer or all these authorities. You need to do a lot of additional efforts to make it possible,” she says. Fortunately, OVOGENE is positioned to handle large-scale transportation of reproductive material, thanks to its history of working with a high number of international clients. About 80 percent of OVOGENE’s patients live outside Ukraine, and the clinic works closely with ARKCryo, a worldwide cryo-shipping company, to handle legal paperwork and logistical issues to get material to people all over the world. Once Dr. Dorofeyeva was able to get frozen material to Bratislava for safer storage, ARKCryo starting shipping material to clients who wanted to access it or store it in a different location. Semi-local foreign clients and nearby Ukrainian refugees have been able to continue some treatments with their frozen material at OVOGENE’s Bratislava clinic.
The preservation of embryos, eggs, and sperm, and continued access to fertility care, may seem an insignificant issue in the larger scope of wartime, but it undoubtedly has a profound impact on the families and individuals involved. Doctors and medical staff across Ukraine know how important it is to keep hope alive, and continue to risk their lives to protect it. The hope of family, specifically, is one powerful version of a peaceful future they aren’t willing to surrender.
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