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Pregnancy loss & early Call your provider

Blighted Ovum

Also known as Anembryonic pregnancy, Empty sac pregnancy. First trimester, usually found around 7–9 weeks.

With a blighted ovum, the pregnancy sac forms and hormones rise, so a test reads positive and you feel pregnant, but no embryo ever grows inside. Also called an anembryonic pregnancy, it usually surfaces when an early ultrasound shows that sac to be empty. A random chromosomal error is behind it, it is nobody's fault, and it does not mean you cannot have a healthy pregnancy.

Know the warning signs When to call a provider
How common
About half of early miscarriages
The leading cause of first-trimester pregnancy loss.
When
First trimester
Usually found on ultrasound around 7 to 9 weeks.
Urgency
Call your provider
Heavy bleeding or feeling faint is a reason for emergency care.
Outlook
Reassuring
It usually does not recur, and most go on to healthy pregnancies.

Understanding it

What is blighted ovum?

A fertilized egg attaches to the uterine wall and a pregnancy takes shape, forming a gestational sac and the start of a placenta, but the embryo never develops or stops so early it is reabsorbed. What remains is an empty sac. Because that sac and early placenta keep making hCG, tests stay positive and early symptoms carry on, so the news often lands as a shock at the first scan.

A blighted ovum is the most common cause of first-trimester miscarriage, roughly half of early losses. Miscarriage ends about 10% to 20% of known pregnancies, and a large share of those, especially the earliest, are blighted ova.

The cause is usually a chromosomal error as egg and sperm combined, a random event that kept the embryo from forming. Nothing you did, ate, or avoided brought it on. Testing does not always find a chromosomal cause, so the trigger is not always clear, but the result is the same: a pregnancy that could not continue.

As a form of early pregnancy loss, it is managed with the same three safe options. The outlook is reassuring: most people who have one go on to a normal, healthy pregnancy, and recurrence is unlikely.

Symptoms

What are the symptoms?

Often there are no symptoms at first, and the diagnosis comes as a surprise at an early scan. When symptoms do appear, they are those of an early miscarriage: light bleeding and mild cramping.

Early signs

  • A positive test and the usual early symptoms, such as tender breasts and nausea
  • Often no symptoms at all, with the loss found on ultrasound
  • Light spotting or vaginal bleeding
  • Mild cramping or pelvic pain
  • Fading pregnancy symptoms as hCG drops

Emergency signs — call 911

  • Heavy vaginal bleeding, more than two pads an hour for two hours in a row
  • Dizziness, fainting, palpitations, or looking very pale, which can signal significant blood loss
  • A fever that does not go away
  • Severe pain that is not relieved by usual pain medicine

Why it matters

Risks to you and baby

The pregnancy cannot continue

A blighted ovum is a pregnancy loss. There is no embryo to develop, and no treatment changes that. Naming it, and grieving it, is part of moving through.

Heavy bleeding

As the tissue passes, bleeding can turn heavy. Soaking more than two pads an hour for two hours, or feeling faint, is a reason to be seen urgently, and rarely a procedure is needed.

Retained tissue and infection

If tissue stays in the uterus, it can cause ongoing bleeding or, uncommonly, an infection marked by fever and pain. Both are treatable with medication or a short procedure.

The emotional weight

Learning at a scan that a pregnancy you felt was real has stopped is a particular kind of grief. It is valid, and support is worth reaching for.

How it's found

How is it diagnosed?

A blighted ovum is diagnosed by transvaginal ultrasound showing an empty gestational sac. Because a normal early pregnancy must never be mistaken for a loss, a repeat scan is sometimes done to be sure.

Transvaginal ultrasound

Shows a gestational sac with no embryo inside. A sac 25 mm or more across with no embryo confirms the diagnosis.

Follow-up ultrasound

If the sac is smaller and the picture uncertain, a repeat scan in a week or two showing no development confirms it, so a viable pregnancy is never ended by mistake.

hCG blood tests

Hormone levels that plateau or fall, rather than rising, support the diagnosis.

Usually at an early dating or reassurance scan, often around 7 to 9 weeks, sometimes prompted by spotting. When findings are borderline, the diagnosis waits for a confirmatory repeat scan.

Treatment

How is it managed?

As an early pregnancy loss, a blighted ovum is managed with the same three safe options. The right choice depends on your situation and preferences; none is safer than the others for a routine loss.

Treatment paths

Expectant management lets your body pass the tissue on its own, which happens for most people within a few weeks. Medical management uses medication to bring it on more predictably. Surgical management is a short procedure, a suction dilation and curettage, to empty the uterus; it is the fastest option and the one used for heavy bleeding or infection.

Medication

The medicine used is misoprostol, often preceded by mifepristone, which makes it more effective. If you are Rh negative, you should receive a Rho(D) immunoglobulin (RhoGAM) injection.

Monitoring

Afterward your provider confirms the uterus is empty and bleeding is settling, and follow-up is a chance to talk about grief and next steps.

Can it recur?

Almost never as a pattern. The chance of another blighted ovum is low, and most people who have one go on to a healthy, full-term pregnancy. It is not a sign of infertility. Two or more losses of any kind are worth an evaluation, but even then the odds of a future healthy pregnancy stay good.

What you can do

Can it be prevented?

  • It cannot be prevented

    A blighted ovum comes from a random chromosomal error, so there is no way to prevent it and nothing you could have done differently.

  • Support your overall health

    Folic acid, managing conditions like thyroid disease and diabetes, and avoiding smoking, alcohol, and recreational drugs all support a healthy pregnancy, even though none can prevent a chromosomal loss.

  • Get RhoGAM if you are Rh negative

    This does not prevent the loss, but it protects a future pregnancy from Rh problems, so make sure it is given if it applies to you.

Who is more at risk

Risk factors

Maternal age
The dominant factor, because the chance of a chromosomal error rises with age.
Roughly 10% of pregnancies at ages 20 to 24 versus about half at ages 40 to 44
A previous early loss
A prior loss modestly raises the risk of another, though most people who lose one pregnancy do not lose the next.
Certain health and lifestyle factors
Uncontrolled diabetes and thyroid disease, and smoking, alcohol, or drug use, are linked to a higher risk of early loss generally.

Do not wait

When to call your provider or 911

  • Go to the ER for heavy bleeding, soaking more than two pads an hour for two hours, or if you feel faint, dizzy, or have palpitations.
  • Seek urgent care for a persistent fever or severe pain not relieved by usual pain medicine, which can signal infection.
  • Call your provider to discuss your options once a blighted ovum is confirmed, and to arrange follow-up.
  • Call if bleeding after treatment does not settle over several days, or stops and turns heavy again, a sign of retained tissue.
  • Reach out if the loss is weighing on you. Grief support is care, and it is available.

Talking to your team

Questions to ask your provider

  • Are you certain this is a blighted ovum, or should we repeat the scan to be sure?
  • Which management option (expectant, medical, or surgical) fits my situation and my wishes?
  • If I am Rh negative, do I need a RhoGAM shot?
  • How will I know the miscarriage is complete, and what follow-up do I need?
  • How long should I wait before trying to conceive again?
  • Is there any reason to do testing before my next pregnancy?

Keep reading

More on blighted ovum

All pregnancy guides articles

Good to Know

Blighted Ovum FAQs

Common questions about blighted ovum, answered.

Why was my pregnancy test positive if there is no embryo?

Because the sac and early placenta still make hCG, even without an embryo. That is why a test reads positive and you feel pregnant, until the scan shows the sac empty.

Did I do something to cause this?

No. A blighted ovum comes from a random chromosomal error as the egg was fertilized. It is not caused by exercise, sex, stress, lifting, diet, or anything you did or did not do.

Does this mean I cannot have a healthy baby?

No. It is not a sign of infertility. Most people who have one go on to a normal, healthy pregnancy, and the chance of another is low.

Do I have to have a procedure?

Not necessarily. Many pass on their own or with medication. A suction procedure is one safe option, and the choice for heavy bleeding, infection, or when you want it handled quickly. The decision is usually yours.

Why might I need a second ultrasound before treatment?

To be certain. Sometimes a pregnancy is just earlier than the dates suggest, so if the sac is small, a repeat scan showing no growth confirms the loss and protects a normal pregnancy from being ended by mistake.

How is this different from a regular miscarriage?

It is a type of miscarriage. Here the sac forms but no embryo develops; in other miscarriages an embryo develops and then stops. The management and outlook are the same.

How long should I wait before trying again?

Physically, many providers say you can try again once your body recovers, often after one normal cycle, though guidance varies. Emotionally, the right time is personal. Ask your provider, and give yourself room to grieve first.

Will I feel the loss even though there was no embryo?

Very possibly, and that is completely valid. You lived a real pregnancy, with real symptoms and real hopes. Grief after a blighted ovum is common, and support is there when you want it.

Medically Reviewed · Updated

Reviewed by Dr. Grace Lin, MD, FACOG · OB-GYN

Obstetrician-gynecologist focused on reproductive and sexual health for women: pregnancy, BV, yeast, trichomoniasis and HPV/cervical screening. Our editorial guidelines →

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