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What is a blighted ovum?

Today on my YouTube channel, Katie Lee CGC Talks Miscarriage and Fertility I discussed my experience with blighted ovums. I explain what a blighted ovum is and why I prefer the term anembryonic pregnancy. I review how anembryonic pregnancies are diagnosed, why they happen, and medical management options.

Check out my video here:

If you’re reading this because you or a loved one has recently been diagnosed with a blighted ovum, I am so sorry. I too have sat with the ultrasound tech at my OB’s office waiting to hear a heartbeat and see a little gummybear baby on the screen only to find out that there was no baby developing at all. I received the diagnosis of a blighted ovum twice. With both pregnancies, I experienced all of the early pregnancy symptoms- nausea, breast tenderness, and fatigue, which led me to believe that everything was going well. I was completely caught off guard to learn that my pregnancy was not developing typically.

What is a blighted ovum? And why I like the term anembryonic pregnancy better.

I hate the term blighted ovum- it reminds me of the plant disease, blight, and it is also a total misnomer. Ovum is a term for a mature egg cell, but a blighted ovum is actually much more than that.

In a typically-developing pregnancy the fetal pole and embryo start developing at the 5-6 week point. With a blighted ovum the gestational sac (sac surrounding the embryo) forms, but the fetal pole and embryo fail to develop, resulting in an empty sac.

So despite the name, a blighted ovum is the product of a fertilized egg that started developing into a pregnancy. For that reason, I much prefer the term anembryonic pregnancy- which perfectly describes this type of miscarriage- a pregnancy that is developing without an embryo. Although the terms blighted ovum and anembryonic pregnancy can be used interchangeably, I will stick with the term anembryonic pregnancy from here out.

How do anembryonic pregnancies happen?

Miscarriages or pregnancy losses can happen in different ways. Approximately 50% of miscarriages in the first trimester are due to anembryonic pregnancies.

Some individuals may experience signs of the anembryonic pregnancy including abnormal bleeding and cramping. Other individuals may completely lack any signs, which is known as a missed miscarriage. In this case, the anembryonic pregnancy would be diagnosed at the pregnant individual’s first ultrasound.

How is an anembryonic pregnancy diagnosed?

An anembryonic pregnancy can be detected in the first ultrasound. If the ultrasound reveals an empty gestational sac, this could be an indication of an anembryonic pregnancy. However, the lack of a visible fetus, could also be due to incorrect pregnancy dating which can happen if a pregnant person is not sure of the date she conceived. If the pregnancy dating is not accurate, the individual may be earlier in her pregnancy than was previously assumed. If this is the case, the pregnancy may simply need an additional week or two to continue developing. A follow-up ultrasound 1-2 weeks later can confirm whether the embryo started to develop or whether the sac is still empty which would confirm an anembryonic pregnancy.

Why do anembryonic pregnancies happen?

Miscarriages, including anembryonic pregnancies, can occur for a variety of reasons. Unfortunately, the cause is often not determined unless additional testing can be performed.

One of the most common causes of first trimester losses is chromosome abnormalities.

If tissue from the pregnancy can be collected, your doctor may be able to order genetic testing that can confirm if the cause of the loss was chromosome abnormalities. If you would like to learn more about whether this is an option for your loss, discuss this with your doctor. Check out my YouTube video here - to learn more about genetic testing on miscarriage tissue.

Medical Management of Anembryonic Pregnancies

There are three management options that are typically offered for anembryonic pregnancies:

1. Expectant management: The patient waits until the tissue spontaneously passes. There are no medical management practices for this approach, and there are regular ultrasounds to

check to see if the tissue is passing through.

2. Medical management: Medication is taken vaginally or orally, depending on your

preference and your doctor’s recommendation. The medication starts the process of

passing the tissue.

3. Surgical treatment: A procedure known as D&C (Dilation and curettage) can be performed. The doctor can remove the pregnancy tissue from the uterus during the procedure.

If you or your loved one has been diagnosed with an anembryonic pregnancy, you can consider asking the doctor the following questions:

  1. What option do you recommend for medical management?

  2. Can you explain the pros and cons of each management option?

  3. Would genetic testing on the tissue from the loss be warranted to understand why this happened?

  4. What are the chances of this happening again?

  5. What is my prognosis for a successful pregnancy next time?

  6. When can I try to conceive again?

What is the prognosis for future pregnancies?

Most people who experience an anembryonic pregnancy will go on to have a successful pregnancy in the future.

Emotional Impact of Anembryonic Pregnancies

It took me months to emotionally recover from my anembryonic pregnancies. Know that early losses can be devastating. It can be hard for others to understand the pain of your loss, as they may not have known you were pregnant yet, but your feelings are valid and you are not alone in them. Consider reaching out to others for support, joining a Facebook group or other support group for those who have experienced pregnancy loss, or seeing a therapist.

This content is for educational and informational purposes only. Please contact your doctor or another qualified healthcare provider with any questions you may have regarding medical advice, your condition, or treatment.

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