What Is a Blighted Ovum? Symptoms, Causes, and What Happens Next
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is a blighted ovum?
A blighted ovum, also called an anembryonic pregnancy, is an early miscarriage in which a fertilized egg implants in the uterus but no embryo develops, leaving an empty gestational sac. [3] [5] It is the number one cause of first-trimester miscarriage. [3] Only a transvaginal ultrasound can confirm it, and most people who experience one later have a healthy, full-term pregnancy.
What the research says
About half of pregnancy-loss tissue samples show chromosome abnormalities. A meta-analysis of seven large case series covering 35,130 products of conception found chromosomal abnormalities in approximately 50% of cases using chromosome microarray analysis. This supports the explanation that chromosome errors are a leading cause of early pregnancy loss, including a blighted ovum (Peng et al., Molecular Genetics & Genomic Medicine, 2023). [1]
Medication can reduce the need for surgery in missed miscarriage. In the MifeMiso randomized trial of 711 women in the UK with a diagnosed missed miscarriage, 17% of those given mifepristone before misoprostol failed to pass the gestational sac within 7 days, compared with 24% of those given placebo before misoprostol (risk ratio 0.73, 95% CI 0.54 to 0.98). Surgery was needed in 17% versus 25%. The trial did not compare medication with waiting or surgery (Devall et al., Health Technology Assessment, 2021). [2]
Key takeaways
A blighted ovum is an early miscarriage in which the gestational sac grows but no embryo ever develops. [3] It is the leading cause of first-trimester miscarriage and is usually caused by chromosomal problems during cell division, not by anything you did. You may still have pregnancy symptoms and a positive test because the placenta keeps releasing hormones. [3] An ultrasound is the only way to confirm it. Treatment may be a natural miscarriage, medication, or a D&C procedure, and most people who have a blighted ovum go on to have a healthy, full-term pregnancy. [3]
What Is a Blighted Ovum?
A blighted ovum, also called an anembryonic pregnancy, is a type of early miscarriage. It happens when a fertilized egg implants into the uterus but does not develop into an embryo. [3] [5]
The fertilized egg stops growing, but the gestational sac — the structure where the embryo would develop — keeps growing. The placenta and the empty sac continue to release pregnancy hormones, even with no embryo present. That is why you can still have early pregnancy symptoms or even a positive pregnancy test. [3]
Sometimes a blighted ovum happens so early in pregnancy that you never know you were pregnant at all. [3] [5]
How Pregnancy Develops — and Where It Stops
During normal fetal development, a fertilized egg turns into a blastocyst. At around four weeks of pregnancy, this blastocyst implants in the wall of the uterus and develops into an embryo. [3]
With a blighted ovum, the embryo never forms or stops growing after it forms. This may happen because your body recognizes a chromosomal problem and naturally stops the pregnancy from continuing. [3]
There are three possible scenarios:
Scenario | What Happens |
Very early blighted ovum | It happens so early that you never realize you are pregnant [3] |
Discovered at the first ultrasound | You have a positive test and pregnancy signs, then discover the empty sac at your first scan [3] |
Miscarriage follows | You have a positive test and signs of pregnancy, then experience a miscarriage [3] |
A blighted ovum is the number one cause of first-trimester miscarriages. [3]
Signs of a Blighted Ovum
A blighted ovum can occur so early in pregnancy that you never know you were pregnant. In other cases, you may experience typical early pregnancy signs, such as a missed menstrual period, a positive pregnancy test, breast tenderness, and morning sickness. [3]
If a blighted ovum leads to a natural miscarriage, you will notice bleeding and cramping. [3] The table below summarizes what you may experience.
The only way to confirm a blighted ovum is through an ultrasound, which will show an empty gestational sac. [3]
Causes and Risk Factors
A blighted ovum is usually the result of chromosomal problems that occur during cell division. This can happen because the egg or sperm is poor quality, or because of an error that occurs at random. [3] [5]
After conception, the egg begins to divide shortly after being fertilized by sperm. Around 10 days later, all of these new cells form an embryo. With a blighted ovum, the embryo never forms or stops growing after it forms. This may be because your body recognizes there is a chromosomal problem and naturally stops the pregnancy from continuing. [3]
Risk Factors
Healthcare providers do not know exactly why chromosomal problems occur during fetal development, but certain factors can increase your risk: [3]
Possible Complications
Complications of a blighted ovum are uncommon, but they can include: [3]
How a Blighted Ovum Is Diagnosed
Your healthcare provider will diagnose a blighted ovum using a transvaginal ultrasound. This happens in the first trimester, usually between seven and nine weeks of pregnancy — an embryo should be visible by that time. [3]
The exam is similar to a pelvic exam. You lie back on an exam table with your feet in stirrups, and the provider places an ultrasound wand into the vagina to see the contents of the uterus. A blighted ovum appears as an empty sac — almost like a bubble. [3]
Many people are unaware they have a blighted ovum because the placenta keeps releasing hormones, making the body think it is pregnant. This is also why pregnancy symptoms and positive tests persist. [3]
hCG Blood Tests
Some providers collect a series of blood samples to check hCG (human chorionic gonadotropin) levels. hCG rises rapidly in early pregnancy and peaks around weeks eight to ten. If it is not rising quickly or is low, it can indicate a miscarriage or another complication. [3]
Diagnostic Step | What It Shows |
Transvaginal ultrasound | An empty gestational sac (usually checked at 7–9 weeks) [3] |
Series of hCG blood tests | Whether hormone levels are rising normally over several days [3] |
Repeat ultrasound after symptoms | Checks the contents of the uterus if bleeding or miscarriage signs have started |
How Long Can It Go Undetected?
The amount of time you can carry a blighted ovum varies. The placenta keeps growing and releasing hormones without an embryo. For some people, a miscarriage occurs within a few days of a positive pregnancy test. Others discover the blighted ovum only at their first ultrasound appointment. [3]
Treatment Options
For some people, no treatment is needed because the body passes the tissue through the vagina on its own — a natural miscarriage. If the tissue is not fully passed, there are other options to remove the contents of the uterus. Your provider will walk you through the choices. [3]
Option | How It Works |
Natural miscarriage (watch and wait) | If it is safe, you wait for the body to release the pregnancy tissue; can take days or weeks to start [3]; cramping, abdominal pain, and bleeding occur once it begins |
Medication-induced miscarriage | Misoprostol, with or without mifepristone, triggers the miscarriage; cramping, pain, and bleeding begin within 30 minutes to 10 hours of taking the medication [3] |
Dilation and curettage (D&C) | A surgical procedure under sedation or general anesthesia; the cervix is opened and tools with suction remove the remaining pregnancy tissue [3] |
A follow-up appointment is usually scheduled four to six weeks after a miscarriage or D&C. You may receive another ultrasound to confirm the uterus is empty, and your provider will check for signs of infection or other complications. [3]
What a Miscarriage Feels Like
A blighted ovum miscarriage causes vaginal bleeding and abdominal cramping. A miscarriage usually feels more intense than a regular menstrual period. You can take over-the-counter medicine like acetaminophen to relieve cramping. Avoid lifting anything heavy or doing strenuous exercise, as it can increase bleeding. You may experience spotting for several weeks after a miscarriage. [3]
Recovery After a Blighted Ovum
Recovering from a blighted ovum miscarriage or D&C can last from one or two weeks up to a month. Cramping generally lasts up to a week, but bleeding can last several weeks. Your bleeding should get lighter until it stops completely. [3]
You can resume normal activities when you feel comfortable, but bleeding can increase with strenuous activity or exercise. Remaining hormones may delay your menstrual cycle — most people get their period within four to six weeks after a blighted ovum. [3]
It may take longer to recover emotionally. You may feel sadness, anger, or confusion. It is OK to take time to grieve. Ask friends and family for support during your recovery. [3]
Outlook and Future Pregnancy
Most healthcare providers recommend having one or two regular menstrual cycles before trying to conceive again after any type of miscarriage. Check with your provider before trying again. [3]
Can you still have a baby? Yes. Most people who have a blighted ovum go on to have a healthy, full-term pregnancy afterward. [3]
Will it happen again? The chances of having another blighted ovum are low. If you experience more than one, your provider may suggest genetic testing to determine whether there is an underlying cause. [3]
Prevention
There are no ways to prevent a blighted ovum. Some couples may want genetic testing on the tissue from the uterus, which checks for underlying causes of miscarriage and can be helpful for couples who have experienced multiple pregnancy losses. [3]
When to Contact Your Healthcare Provider
Call your healthcare provider right away if you have any of these symptoms:
Warning Sign | What to Do |
Excessive vaginal bleeding | Call your provider right away |
Dizziness or fainting | Call your provider right away |
Fever that does not go away | Call your provider right away |
Symptoms that worsen over time | Call your provider right away |
Severe pain not relieved by pain medicine | Call your provider right away |
When to go to the ER: Go to the nearest ER if you experience heavy vaginal bleeding — more than two pads per hour for two consecutive hours — or symptoms of anemia such as dizziness, palpitations, or paleness. [3]
Questions to Ask Your Doctor
Losing a pregnancy is upsetting and confusing. It is completely normal to have questions and feel emotional during this time. Some questions you may want to ask include:
Can I let my body miscarry, or should I take medication to induce a miscarriage?
What are the risks of miscarriage?
Do I have to have a D&C?
What are the risks of a D&C?
How long can I expect to bleed or have cramping?
Is there any indication this will happen again?
When can I start trying to conceive?
Do I need to come back for another ultrasound?
Conclusion
A blighted ovum is a difficult but surprisingly common experience, and it is almost never caused by anything you did. Understanding that it is the leading cause of first-trimester miscarriage — and that it stems from random chromosomal events during cell division — helps remove the guilt and self-blame many people carry after a loss.
The path forward is straightforward: an ultrasound confirms the diagnosis, and you and your provider choose between natural miscarriage, medication, or a D&C procedure. Physical recovery typically takes a few weeks, while emotional healing deserves its own time and support. Most importantly, the outlook is encouraging — most people who experience a blighted ovum go on to have a healthy, full-term pregnancy.
Frequently Asked Questions (FAQ)
What is the difference between a blighted ovum and a miscarriage?
A blighted ovum is a type of miscarriage. A miscarriage is defined as a pregnancy loss before 20 weeks, and a blighted ovum is considered an early miscarriage because it occurs before 13 weeks. The distinguishing feature is that the gestational sac grows but no embryo ever develops. [3]
Why is a pregnancy test positive with a blighted ovum?
The placenta and the empty gestational sac keep releasing pregnancy hormones, even without an embryo present. These hormones trigger a positive pregnancy test and early pregnancy symptoms. [3]
Can a blighted ovum go undetected?
Yes. It can happen so early that you never know you were pregnant, or you may discover it at your first ultrasound after a positive test. Some people experience a natural miscarriage days after a positive test. [3]
Is a blighted ovum more common with IVF?
No. The chances of having a blighted ovum with IVF treatment are about the same as with natural conception. [3]
What causes a blighted ovum?
It is usually the result of chromosomal problems during cell division, which can happen because the egg or sperm is poor quality or due to a random error. The body may recognize the problem and naturally stop the pregnancy from growing. [3] [5]
Did I do something to cause a blighted ovum?
No. There is nothing you did to cause it, and there are no ways to prevent it. The chromosomal errors involved are random events that occur during cell division.
What are the symptoms of a blighted ovum?
You may have normal early pregnancy signs — missed period, positive test, breast tenderness, morning sickness. If a natural miscarriage occurs, symptoms include vaginal bleeding (spotting to passing light gray tissue or clots) and mild to moderate cramping in the pelvic and abdominal area. [3]
How is a blighted ovum diagnosed?
Only an ultrasound can confirm it. A transvaginal ultrasound, usually performed between seven and nine weeks, will show an empty gestational sac. hCG blood tests tracked over several days can also support the diagnosis. [3]
What does a blighted ovum look like on ultrasound?
It appears as an empty sac — almost like a bubble — inside the uterus, with no visible embryo at a stage when one should be detectable (typically seven weeks or later). [3]
Do I need treatment for a blighted ovum?
Not always. If your body passes the tissue naturally, no treatment may be needed. Otherwise, options include waiting for a natural miscarriage, taking misoprostol (with or without mifepristone), or having a D&C surgical procedure. [3]
How long does recovery take?
Physical recovery lasts from one or two weeks up to a month. Cramping lasts up to a week, bleeding can last several weeks, and most people get their period within four to six weeks. Emotional recovery may take longer. [3]
When can I get pregnant again?
Most providers recommend waiting for one or two regular menstrual cycles before trying to conceive again, and checking in with your provider first. [3]
Will a blighted ovum happen again?
The chances of having another blighted ovum are low, and most people go on to have a healthy, full-term pregnancy. If you experience more than one, genetic testing may be recommended. [3]
What are the complications of a blighted ovum?
Complications are uncommon but can include excessive bleeding or hemorrhage, infection, scarring from a D&C procedure, and tears in the uterus from a D&C procedure. [3]
When should I go to the ER during a miscarriage?
Go to the nearest ER if you have heavy vaginal bleeding — more than two pads per hour for two consecutive hours — or signs of anemia such as dizziness, palpitations, or paleness. [3]
Is genetic testing available after a blighted ovum?
Yes. Genetic testing can be done on the pregnancy tissue to check for underlying causes. It is especially helpful for couples who have experienced multiple pregnancy losses. [3]
Related Reading
Sources
Peng G, Zhou Q, Chai H, et al. Estimation on risk of spontaneous abortions by genomic disorders from a meta-analysis of microarray results on large case series of pregnancy losses. Mol Genet Genomic Med. 2023;11(8):e2181. PMID 37013615. https://doi.org/10.1002/mgg3.2181
Devall A, Chu J, Beeson L, et al. Mifepristone and misoprostol versus placebo and misoprostol for resolution of miscarriage in women diagnosed with missed miscarriage: the MifeMiso RCT. Health Technol Assess. 2021;25(68):1-114. PMID 34821547. https://doi.org/10.3310/hta25680
Cleveland Clinic. Blighted Ovum. Cleveland Clinic. Last updated September 9, 2024. https://my.clevelandclinic.org/health/diseases/21924-blighted-ovum
Carlson K, Tafti D. Anembryonic Pregnancy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; updated March 21, 2026. PMID: 29763113. https://www.ncbi.nlm.nih.gov/books/NBK499938/
American Pregnancy Association. Blighted Ovum. American Pregnancy Association. Last revised April 10, 2026. https://americanpregnancy.org/pregnancy/blighted-ovum/
The Miscarriage Association (Miscarriage UK). Anembryonic pregnancy ('blighted ovum'). Miscarriage UK. Accessed October 30, 2026. https://www.miscarriageuk.org/types-of-pregnancy-loss/anembryonic-pregnancy/
Johnson B. Overcoming a 'pseudo pregnancy': Blighted ovums can cause miscarriage. American Osteopathic Association, Find a DO. Published May 8, 2017. https://findado.osteopathic.org/overcoming-a-pseudo-pregnancy
Disclaimer
This article is for general informational purposes only and does not constitute medical advice. It is based on published health information and should not replace consultation with a qualified healthcare professional. Always seek personalized medical guidance for diagnosis, treatment, and decisions about your pregnancy and reproductive health.
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