What Is a Blighted Ovum?

Miscarriages are, unfortunately, quite common. Between one-third to one-half of all pregnancies end in miscarriage. Perhaps the most common reason for a miscarriage is something called a blighted ovum, which is when an egg implants into the uterus but an embryo never grows in the gestational sac. A blighted ovum is the most common type of miscarriage that occurs in the first trimester, and is also referred to as an anembryonic pregnancy.

Meleen Chuang, MD, medical director of women’s health at the Family Health Centers at NYU Langone, explains that a blighted ovum occurs when a gestational sac forms, but no embryo forms inside the sac. “This is not a viable pregnancy and can often be confused with a very early pregnancy with a fetus not yet developed, especially if the patient is uncertain of her last menstrual period,” she describes.

However, the same risk factors that apply to other early pregnancy losses (EPL) also apply to blighted ova, says Dr. Roelands. These include maternal conditions where metabolic or hormonal pathways are involved such as diabetes, lupus, thyroid issues, and PCOS.

Pregnant individuals who experience obesity, substance abuse, uterine abnormalities, infections, or are of advanced maternal age are also at higher risk of early miscarriages, says Dr. Roelands. Abnormalities in the growing embryo also come into play, including chromosomal conditions like monosomy, trisomy, and gene translocations, Dr. Roelands adds.

Signs and Symptoms of a Blighted Ovum

People who have a blighted ovum will have all of the usual signs of pregnancy, such as nausea, sore breasts, and a missed period, says Dr. Roelands. “It is not until the body recognizes the pregnancy is not going forward that she may experience cramping and bleeding,” she says.

Some pregnant individuals don’t know they have a blighted ovum because they start miscarrying before it can be recognized on an ultrasound. Others will have a first-trimester ultrasound that will reveal an empty gestational sac. Ultrasound is the only way to know for sure that you have a blighted ovum.

How Is a Blighted Ovum Treated?

Before any kind of medical intervention is introduced for a blighted ovum, it’s very important that your healthcare provider confirm your diagnosis. Dr. Roelands explains that this usually requires more than one ultrasound.

“You need two moments in time to assess if an embryo is growing at an appropriate rate,” she explains. “This confirmation requires two ultrasounds that demonstrate no progression of the pregnancy.” After this confirmation, you will then be given options for how to treat your blighted ovum.

Sadly, there is nothing that can be done to save your pregnancy when you have a blighted ovum. Most of the time, you will experience cramps and bleeding and spontaneously miscarry, says Dr. Chuang. Other times, you will need medication that will induce a miscarriage, such as misoprostol.

Still, others will need more intervention, including a procedure known as dilation & curettage (D&C). “Surgical management with a gentle suction device can also be done in the office to help remove the pregnancy tissue,” Dr. Chuang says. Surgeries such as D&C require sedation or general anesthesia.

Getting Pregnant After a Blighted Ovum

Learning that you have a blighted ovum and therefore an unviable pregnancy can be devastating news. Besides your feelings about your pregnancy loss, you are also probably concerned about what this means in terms of getting pregnant in the future.

The good news is that having a blighted ovum shouldn’t have any bearing on your ability to get pregnant and have a healthy pregnancy. “Most women conceive after a blighted ovum,” Dr. Roelands assures. “It does not affect your fertility.”

According to the American College of Obstetricians and Gynecologists (ACOG), having one first trimester loss rarely has bearing on future pregnancy losses. However, if you have two or more losses, ACOG recommends testing to rule out any medical issues that may be causing the losses. Per ACOG, in 50 to 75% of women with repeated miscarriages, no cause can be found for the pregnancy loss.".

In terms of when to try again, Dr. Chuang recommends continuing to take your prenatal vitamins and then waiting for one to two menstrual cycles before trying again. Different healthcare providers may have different advice about when it’s a good time to try again, and it may differ from one person to another, so be sure to reach out to your provider for options.

The truth is that pregnancy loss is more common than we think, says Dr. Roelands, and that the rates are likely higher than we realize because many people don’t disclose what they’ve experienced. Dr. Roelands emphasizes that if you’ve experienced a blighted ovum, your feelings of grief are understandable and that you should honor your feelings. Give yourself the time and space to grieve, she recommends.

“I encourage women to reach out to their mothers, family members, or friends they trust to support them,” she says. “Many will hear stories from those women and realize it is more common than discussed.”

A Word From Verywell

Just because a blighted ovum is a common cause of miscarriage doesn’t mean that your experience is something to dismiss. Early miscarriages can be emotionally intense, and the fact that most of us don’t talk openly about these experiences often means that we must grieve alone.

It’s so important to reach out for support, and speak to a counselor or therapist if your feelings about your loss are hard to manage. It’s also vital to follow up with your healthcare provider to discuss any concerns you have about your loss, and to keep in touch if and when you decide to try for another baby.