Blighted Ovum

Medically Reviewed by Nivin Todd, MD on April 29, 2023
3 min read

A blighted ovum occurs when a fertilized egg implants in the uterus but doesn't develop into an embryo. It is also referred to as an anembryonic (no embryo) pregnancy and is a leading cause of early pregnancy failure or miscarriage. Often it occurs so early that you don't even know you are pregnant.

A blighted ovum causes about one out of two miscarriages in the first trimester of pregnancy. A miscarriage is when a pregnancy ends on its own within the first 20 weeks.

When a woman becomes pregnant, the fertilized egg attaches to the uterine wall. At about five to six weeks of pregnancy, an embryo should be present. At about this time, the gestational sac -- where the fetus develops -- is about 18 millimeters wide. With a blighted ovum, though, the pregnancy sac forms and grows, but the embryo does not develop. That's why a blighted ovum is also called an anembryonic pregnancy.

Miscarriages from a blighted ovum are often due to problems with chromosomes, the structures that carry genes. This may be from a poor-quality sperm or egg. Or, it may occur due to abnormal cell division. Regardless, your body stops the pregnancy because it recognizes this abnormality.

It's important to understand that you have done nothing to cause this miscarriage and you almost certainly could not have prevented it. For most women, a blighted ovum occurs only once.

With a blighted ovum, you may have experienced signs of pregnancy. For example, you may have had a positive pregnancy test or a missed period.

Then you may have signs of a miscarriage, such as:

  • Abdominal cramps
  • Vaginal spotting or bleeding
  • A period that is heavier than usual.

If you're experiencing any of these signs or symptoms, you may be having a miscarriage. But not all bleeding in the first trimester ends in miscarriage. So be sure to see your doctor right away if you have any of these signs.

If you thought you had a normal pregnancy, you're not alone; many women with a blighted ovum think so because their levels of human chorionic gonadotropin (hCG) may increase. The placenta produces this hormone after implantation. With a blighted ovum, hCG can continue to rise because the placenta may grow for a brief time, even when an embryo is not present.

For this reason, an ultrasound test is usually needed to diagnose a blighted ovum -- to confirm that the pregnancy sac is empty.

If you have received a diagnosis of a blighted ovum, discuss with your doctor what to do next. Some women have a dilation and curretage (D and C). This surgical procedure involves dilating the cervix and removing the contents of the uterus. Because a D and C immediately removes any remaining tissue, it may help you with mental and physical closure. It may also be helpful if you want a pathologist to examine tissues to confirm the reason for the miscarriage.

Using a medication such as misoprostol on an outpatient basis may be another option. However, it may take several days for your body to expel all tissue. With this medication, you may have more bleeding and side effects. With both options, you may have pain or cramping that can be treated.

Other women prefer to forego medical management or surgery. They choose to let their body pass the tissue by itself. This is mainly a personal decision, but discuss it with your doctor.

After a miscarriage, your doctor may recommend that you wait at least one to three menstrual cycles before trying to conceive again.