{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T01:47:19Z","timestamp":1782265639542,"version":"3.54.5"},"reference-count":32,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T00:00:00Z","timestamp":1782000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Obstructed HemiVagina and Ipsilateral Renal Anomaly (OHVIRA) syndrome, also known as Herlyn\u2013Werner\u2013Wunderlich syndrome, is a rare congenital M\u00fcllerian duct anomaly, characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Symptoms typically appear shortly after menarche and include dysmenorrhea and pelvic pain. The psychological burden associated with fertility and reproductive outcomes in women with OHVIRA syndrome remains poorly investigated. Materials and methods: A 30-year-old primigravida with left renal agenesis and a history of vaginal abscess, dysmenorrhea, and chronic pelvic pain received a delayed OHVIRA syndrome diagnosis. The patient had previously been informed that spontaneous conception and an uncomplicated pregnancy were highly unlikely because of her congenital gynecological condition, resulting in significant fertility-related anxiety and psychological distress. Under careful supervision and counseling, she conceived successfully, and the pregnancy progressed without complications; an elective cesarean section was performed at term. A literature search using the PubMed and Embase databases was conducted between November 2025 to April 2026 to identify studies reporting reproductive outcomes and psychological aspects in patients diagnosed with OHVIRA syndrome and other M\u00fcllerian anomalies. Results: Evidence-based counseling contributed to improvement of quality of life and reduction of pregnancy-related anxiety of the reported patient with OHVIRA syndrome. A limited number of studies discuss the mental burden and fertility-related anxiety of patients with OHVIRA syndrome and other M\u00fcllerian anomalies. Conclusions: Spontaneous conception and uncomplicated pregnancy are possible for women with OHVIRA syndrome. The psychological burden associated with congenital gynecological conditions remains under-recognized and requires further investigation. Comprehensive counseling and interdisciplinary care are essential to improve reproductive education, mental health support, and pregnancy outcomes in patients with congenital gynecological anomalies.<\/jats:p>","DOI":"10.3390\/jcm15124806","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T01:03:23Z","timestamp":1782263003000},"page":"4806","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fertility, Pregnancy, and Psychological Burden in OHVIRA Syndrome: Clinical Case Study and Review of the Literature"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2473-3172","authenticated-orcid":false,"given":"Natalia Katarzyna","family":"Mazur-Ejankowska","sequence":"first","affiliation":[{"name":"Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdansk, 80-210 Gdansk, Poland"},{"name":"Clinic of Obstetrics and Gynecology, Gynecological Oncology and Endocrine Gynecology, University Clinical Centre, 80-952 Gdansk, Poland"},{"name":"First Doctoral School, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3969-6836","authenticated-orcid":false,"given":"Zuzanna Ma\u0142gorzata","family":"Brz\u00f3ska","sequence":"additional","affiliation":[{"name":"Division of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Ejankowski","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdansk, 80-210 Gdansk, Poland"},{"name":"Clinic of Obstetrics and Gynecology, Gynecological Oncology and Endocrine Gynecology, University Clinical Centre, 80-952 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1806-2879","authenticated-orcid":false,"given":"Amelia","family":"Sztangierska","sequence":"additional","affiliation":[{"name":"Division of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinga","family":"Jaguszewska","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdansk, 80-210 Gdansk, Poland"},{"name":"Clinic of Obstetrics and Gynecology, Gynecological Oncology and Endocrine Gynecology, University Clinical Centre, 80-952 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariusz Grzegorz","family":"Wydra","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdansk, 80-210 Gdansk, Poland"},{"name":"Clinic of Obstetrics and Gynecology, Gynecological Oncology and Endocrine Gynecology, University Clinical Centre, 80-952 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5311-3450","authenticated-orcid":false,"given":"Magdalena Emilia","family":"Grzybowska","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdansk, 80-210 Gdansk, Poland"},{"name":"Clinic of Obstetrics and Gynecology, Gynecological Oncology and Endocrine Gynecology, University Clinical Centre, 80-952 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"653.e1","DOI":"10.1016\/j.jpurol.2021.06.023","article-title":"Multiple variants of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome\u2014One clinical center case series and the systematic review of 734 cases","volume":"17","author":"Kudela","year":"2021","journal-title":"J. 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