Understanding a Blighted Ovum: What It Means for Early Pregnancy

Although it isn’t out of the ordinary for an early pregnancy to end before you even realize it began, this doesn’t make the fact any easier to process once you find out. Let’s take a look at what it means to have a blighted ovum, including its symptoms and what it implies for future pregnancies.

At conception, a sperm fertilizes an egg and eventually forms an embryo that implants in the uterus. This triggers the development of the placenta and the production of important pregnancy hormones, including human chorionic gonadotropin (hCG).

A “blighted ovum” is what you have when a fertilized egg implants and develops a gestational sac, but the embryo either doesn’t form or ceases to grow very early on. This means the pregnancy isn’t viable.

A blighted ovum is a relatively common type of early pregnancy loss that happens before the end of the first trimester. Fortunately, having one doesn’t mean you can’t have a successful pregnancy later. 1

What causes a blighted ovum?

Exactly what causes a blighted ovum isn’t always clear, but experts usually point to a few suspects: 2

• Chromosomal abnormalities: The most common cause of a blighted ovum is a random event in which the egg or sperm has an incorrect number of chromosomes. This immediately pumps the brakes on embryonic development.
• Other genetic factors: Sometimes, other random genetic mutations damage the quality of the sperm or egg and make the resulting embryo unfit for growth.

It’s also possible that obesity, advanced maternal age (over 35), and hormonal imbalances also increase the risk of early pregnancy loss from various causes, including a blighted ovum.

Whatever the situation, don’t blame yourself or your partner if this happens to you. The pure randomness of the event means there’s nothing you could have done to prevent it.

What are the symptoms of a blighted ovum?

Initially, a blighted ovum shows all the signs of a normal pregnancy, as the placenta still develops and produces hCG. Along with a positive pregnancy test, you can expect the hallmark early pregnancy symptoms like morning sickness, breast tenderness, fatigue, and bloating.

Since your pregnancy won’t progress, however, these symptoms will eventually fade and give way to signs of a miscarriage, including: 3 4

• Bleeding: Usually, you’ll have light spotting when you lose your pregnancy. (If you have heavier bleeding, let your doctor know.)
• Cramping: You’ll likely have mild cramping in your lower belly. If your cramps become more severe and don’t ease up with pain medication, you should similarly let your doctor know right away. 5
• Decreasing hCG levels: Your blood tests will sometimes show a surprising drop-off of hCG, indicating that you’re no longer pregnant.

You can only spot a blighted ovum via a transvaginal ultrasound, usually after 6 weeks into your pregnancy. The visual will pick up either an empty gestational sac or one that’s smaller than expected for the gestational age.

If you have an ultrasound before 6 weeks, the sac could be all that’s visible, even in a normal pregnancy. Expect your doctor to schedule a follow-up ultrasound in a week or two to confirm the diagnosis. 6

During the ultrasound, your doctor will rule out other conditions, such as an ectopic pregnancy (a fertilized egg implanting outside the uterus). Blood tests can also identify a blighted ovum through hCG levels that initially rise but then plateau or decline.

What to expect after your diagnosis

Once your doctor determines you have a blighted ovum, you’ll have a few different options to manage the miscarriage, which include:

• Expectant management: You allow your body to miscarry naturally and pass the tissue on its own. The wait takes anywhere from several days to a few weeks. Expect heavier bleeding and cramping, comparable to but heavier than your regular menstrual cycle. 7
• Medication: Your doctor can introduce a medication like misoprostol orally or vaginally to induce the miscarriage and help pass the tissue. The process lasts 1 to 2 days, with bleeding and cramping beginning within a few hours. 8
• Surgical procedure: If you want a quicker process or have other medical needs that necessitate immediate action (e.g., severe bleeding or an infection), you can opt for dilation and curettage (D&C). The procedure involves using either suction or a curette (a sharp spoon-shaped device) to remove the tissue. 9

Your doctor will evaluate which option is best for you depending on your circumstances. Don’t hesitate to ask any questions you have or raise any doubts with them.

Losing a pregnancy due to a blighted ovum is physically and emotionally draining. Here are some things you can do to help yourself heal.

Physical recovery

To lower the risk of infection, you should avoid inserting anything into the vagina for 1–2 weeks after your miscarriage (this means avoiding both tampons and sex for a little bit).

Let your doctor know about any lasting symptoms like fever, chills, or severe pain. Heavy bleeding (i.e., soaking through multiple pads an hour for more than 2 hours) can likewise signal complications warranting a call to your doctor. 10

Emotional support and coping

It’s normal to feel sadness, anger, confusion, or guilt over your loss, and you shouldn’t suppress these emotions.

Talk through things with your partner, family, friends, therapist, or support group (online or in person). Focus on self-care for a little while, whether that involves eating healthy (but tasty) foods, sleeping in, or just enjoying a hobby that brings you peace of mind.

Planning for future pregnancies

If you feel yourself wondering how your experience with a blighted ovum will affect your ability to get pregnant in the future, take heart. Most women go on to have healthy, full-term pregnancies afterwards. 11

Some doctors recommend waiting until you’ve had 1 to 3 normal menstrual cycles before giving pregnancy another go. Make an appointment to get a feel for your situation. 12

If you’ve had two or more miscarriages back to back (recurrent or repeat miscarriage), your doctor can test you for underlying problems, like genetic conditions, uterine scarring, or a hormonal imbalance. 13

Losing a baby, no matter how early on you were, causes a very particular kind of heartbreak. Know you’re not alone with all the big feelings that come with this. You’ll get a second chance—hang in there!