A miscarriage can be devastating when you have been trying to get pregnant for a while.
Pregnancy loss usually happens early in pregnancy, before the 20th week (1). A blighted ovum is one such early pregnancy failure that accounts for 50% of all miscarriages (2). Although an unfortunate occurrence, a blighted ovum does not affect your chances of getting pregnant again. In this MomJunction post, we will explain what a blighted ovum is, how it is diagnosed, managed and prevented.
What Is A Blighted Ovum?
A blighted ovum occurs when a fertilized egg implants into the uterine wall but does not develop into an embryo. It is otherwise called anembryonic (no embryo) pregnancy. Cells grow to form the embryonic sac but fail to develop the embryo.
The early embryo produces the human chorionic gonadotropin (hCG), because of which the blood and urine tests for pregnancy show positive. Women might also have pregnancy symptoms such as nausea and sore breasts but it eventually results in a miscarriage (3).
What Causes A Blighted Ovum?
The causes of a blighted ovum are not apparent, but the most common reasons could be (4).
- Chromosomal abnormalities (trisomies with monosomy X and triploidy are responsible for almost 90% cases of sporadic miscarriage)
- Poor quality of sperm or egg
- Structural defects of the uterus
Advancing maternal age and genetic predisposition (increased likelihood of developing a disease based on the genetic makeup of a person) are also the reasons for early miscarriages due to a blighted ovum (5).
Particular gene polymorphism (Val16Ala polymorphism of MnSOD gene) could result in recurring blighted ovum (6).
If you experience two or more early-stage miscarriages, your doctor may suggest specific tests to understand the underlying causes (7).
Signs And Symptoms Of A Blighted Ovum
As mentioned earlier, the initial symptoms of a blighted ovum are similar to the symptoms of early pregnancy including a positive pregnancy test result, sore breasts and missed periods.
A blighted ovum usually ends before you realize you are pregnant. While it happens, you will notice the signs and symptoms of a miscarriage such as (8):
- Heavier period than usual
- Abdominal cramps
- Vaginal spotting
Since some of these symptoms could also indicate other conditions such as implantation, ectopic pregnancy, and cervical infection, it is recommended that you consult your doctor for a proper diagnosis.
How Common Is A Blighted Ovum?
Around 10 to 20% of all pregnancies end in a miscarriage, and 80% of them occur in the first 12 weeks. Research states that one-third of these early miscarriages before eight weeks of pregnancy is because of a blighted ovum (9).
How Is A Blighted Ovum Diagnosed?
Sometimes, you may lose the pregnancy very early, not knowing it is a blighted ovum. So there are chances that a blighted ovum could be undetected before a miscarriage. In some cases, when the woman has vaginal bleeding as a symptom, a prenatal ultrasound that shows an empty embryonic sac, or no embryo confirms the diagnosis of a blighted ovum. If there is no vaginal bleeding, the condition can only be diagnosed in the first prenatal scan, which is done between 8th and 13th weeks.
Misdiagnosed Blighted Ovum
Some women who have a tilted uterus usually look a week or two behind and could be misdiagnosed of having a blighted ovum. This misdiagnosis will happen if the ultrasound is done earlier than eight weeks. So, you have to wait until nine weeks for an ultrasound, provided there are no complications, to detect a blighted ovum (3).
Also, most doctors confirm blighted ovum by checking the hormonal levels and performing a second ultrasound after a gap of one week (10).
Blighted Ovum Treatment And Management
If you are diagnosed with a blighted ovum, your doctor will take a call on the course of action after discussing the treatment options with you.
- Waiting for natural expulsion of the tissue: You should wait for the body to miscarry naturally, which takes about two weeks. This way, you can avoid using medication or surgery. Research also shows that around 80% of miscarriages occur in the first trimester (11). If you choose to wait for spontaneous expulsion of the conceptus, your doctor would provide you with the information to recognize the early signs of infection (fever, foul smelling discharge, etc.,). You should visit the doctor in the case of heavy bleeding, fainting, dizziness or severe abdominal pain.
- Medications: Your doctor gives you either oral or vaginal medicines to cause a miscarriage. The commonly used medications are Misoprostol or Cytotec. However, it takes some days for the body to expel all the tissue. This method is usually associated with heavy bleeding, abdominal cramps, pains, nausea or diarrhea (12).
- Surgical (Dilation and curettage): This is a surgical procedure to remove the conception tissue. It involves cervical dilation followed by scraping of the tissue contents. However, D&C comes with some risks, such as heavy bleeding, cervical infection, damage to the uterus, weakening of cervix and scarring of the uterus (13).
While some women wait for the body to miscarry naturally, some others feel medically induced miscarriages are safe. The ideal option for you would depend on your gestational age, medical history, and your emotional state.
Can You Prevent Blighted Ovum?
No. Since there is no specific reason for a blighted ovum, it is not possible to prevent it.
A blighted ovum usually occurs once and rarely does it recur. It does not affect your chances of getting pregnant again, but before you try to conceive you should give the body enough time to heal or recover from the trauma of miscarriage. This is one of the reasons why doctors ask couples to wait for one to three regular periods after a miscarriage before trying to get pregnant again. Women experiencing multiple miscarriages should consider genetic testing.
Next, we answer a few more questions on a blighted ovum.
Frequently Asked Questions
1. Can I get pregnant again after experiencing a blighted ovum?
Yes. If you have had a blighted ovum recently, talk to your doctor before planning to get pregnant again. Doctors usually recommend waiting until you have one or more normal periods after a miscarriage (14). A subsequent pregnancy following a blighted ovum pregnancy is more likely to be a normal pregnancy.
2. Are there any complications with future pregnancies?
You are likely to have successful subsequent pregnancies following a blighted ovum, but make sure you wait long enough before trying to conceive again. Until then, eat healthily and maintain a healthy lifestyle. Your doctor will also recommend genetic screening, semen analysis and FSH (follicle stimulating hormone) or AMH (anti-mullerian hormone) tests to determine genetic makeup, sperm quality, and egg quality in the meantime.
3. How long can you carry a blighted ovum?
A blighted ovum, like other types of miscarriage, ends anytime before the first 20 weeks of pregnancy (3).
Experiencing a miscarriage for any reason is painful. While a blighted ovum leads to loss of pregnancy, most women tend to have healthy pregnancies and babies subsequently. While you wait to get pregnant again, talk to your partner or a counselor, or consider joining an online support group to deal with the trauma. It can help you gain confidence and stay positive about future pregnancies.
Do you have any experiences to share? Feel free to write to us in the comment section below.
2. Chaudhry K and Siccardi MA; Blighted Ovum (Anembryonic Pregnancy); StatPearls Publishing (2018)
3. K. Chaudhry; MA. Siccardi; Blighted Ovum (Anembryonic Pregnancy); StatPearls Publishing (2018)
4. Fatemeh B. et al.; Association of heteromorphism of chromosome 9 and recurrent abortion (ultrasound diagnosed blighted ovum): A case report; Iran J Reprod Med (2014)
5. Sahar Shekoohi et al.; Chromosomal Study of Couples with the History of Recurrent Spontaneous Abortions with Diagnosed Blightded Ovum; Int J Mol Cell Med (2013)
6. Asiyeh Moshtaghi et al.; Polymorphism of MnSOD (Val16Ala) gene in pregnancies with blighted ovum: A case-control study; Int J Reprod Biomed (Yazd) (2017)
7. Recurrent Pregnancy Loss; Washington University Physicians
8. Understanding Blighted Ovum; UC San Diego Health
9. Sahar Shekoohi et al.; Chromosomal Study of Couples with the History of Recurrent Spontaneous Abortions with Diagnosed Blighted Ovum; Int J Mol Cell Med (2013)
10. D. A. Nyberg R. A. Filly; Predicting pregnancy failure in ‘empty’ gestational sacs; ISUOG (2017)
11. Early Pregnancy Loss; The American College of Obstetricians and Gynecologists (2015)
12. Abortion (Termination Of Pregnancy); Harvard Health Publishing (2019)
13. J. Lohmann-Bigelow et al.; Does Dilation and Curettage Affect Future Pregnancy Outcomes; Ochsner J (2007)
14. How Long After A Miscarriage To Try Again; The University of Utah (2017)