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Blighted Ovum: When You're Pregnant But There's No Yolk Sac or Embryo
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  • Pregnancy happens when a sperm fertilizes an egg during ovulation, and the fertilized egg then starts repeatedly dividing as it moves down the fallopian tube to the uterus. The cells continue to divide, becoming a "hollow ball of cells" called blastocyst, which attaches itself in the lining of the uterus. After about 10 days, this implantation develops into an embryo, and the process signals the body to start producing the placenta. If the fertilized egg does not develop into an embryo, it is referred to as a blighted ovum or an anembryonic pregnancy, which results in a miscarriage.

    What is a blighted ovum?

    During a pregnant woman's Week 6 ultrasound, an embryo should already be visible. With a blighted ovum, the doctor may still see a tiny gestational sac in the woman's uterus but without the yolk sac typically attached to the embryo. Sometimes, there can be a yolk sac but no fetal pole or a curved structure that will eventually develop into the fetus during pregnancy.

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    The gestational sac and placenta may continue to grow, but without an embryo, the blighted ovum will result in a miscarriage at around Week 7 up to Week 12 of the pregnancy.

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    Possible causes of a blighted ovum

    Expert says about 10 to 20 percent of all pregnancies end in miscarriage, and about 80% of those occur in the first 12 weeks. A third of miscarriages that occur before Week 8 into the pregnancy is due to a blighted ovum. It's not unusual but thought of as rare, possibly due to under-reporting.

    A 2007 study showed that more than two-thirds of blighted ovum cases had chromosomal abnormalities like an extra chromosome or missing one in the developing embryo. Other possible causes of a blighted ovum are genetic mutations and poor-quality egg or sperm.

    A blighted ovum is not a result of something you or your partner did. Since the cause is still unknown, you wouldn't know how to prevent it either. It is likely genetic, and the only thing a couple can do is live and eat healthy when trying to conceive.

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    Signs and symptoms of having a blighted ovum

    Most women may not even know they had blighted ovum because of how early it happens into the pregnancy, just a few weeks into ovulation and fertilization. Sometimes, a woman finds out early if she's pregnant via an at-home pregnancy test kit, only to get a negative test result days later. But experiencing blighted ovum can be as devastating as any other pregnancy loss, especially for couples who have been trying and having difficulty conceiving.

    Because of the growing placenta and rising starts producing human chorionic gonadotropin (hCG), it's difficult to distinguish a healthy pregnancy from one with a blighted ovum. Both start out with the early signs of pregnancy with symptoms such as a missed period, morning sickness, breast tenderness, and bloatedness.

    One could get diagnosed with early miscarriage due to blighted ovum through an ultrasound.

    If you start to experience less than typical signs of pregnancy, such as heavy bleeding and severe abdominal cramping, it may mean something is wrong. Vaginal spotting can be due to implantation, but any sign of bright red discharge warrants a trip to the doctor. Mild cramping, too, is typical in pregnancy, but you should alert your doctor if you have severe cramping.

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    How a doctor will diagnose a blighted ovum

    Doctors are likely to diagnose you have a blighted ovum through an ultrasound that will show an empty uterus or an empty gestational sac from Week 6 of pregnancy onward.

    If the ultrasound shows a gestational sac that's too small to see if there is a yolk sac or a fetal pole inside, your doctor may order a repeat ultrasound a week or two after the first one to be sure. He may also repeat the procedure if you're unsure of the date of your first day of last menstruation, which helps your doctor determine how far along you are into your pregnancy.

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    Treatment options for blighted ovum

    Once your doctor confirms you have a blighted ovum, he will likely discuss three options to address it: dilation and curettage (D&C) procedure to expel the placental tissues in your womb, medication to induce miscarriage, or wait till your body naturally expels the blighted ovum.

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    A D&C, or locally known as "raspa," is a procedure where the doctor softens and dilates your cervix. Your uterus is scraped to remove the blood and placental tissues inside. It doesn't involve any cuts or bruises, but the recovery is similar to giving birth. To some women, having a D&C performed had helped provide immediate closure for their pregnancy loss.

    It may take days, sometimes weeks, before oral medication to induce a miscarriage takes effect. Some women prefer to let the miscarriage happen naturally. Since a blighted ovum will eventually result in a miscarriage with or without medical intervention, the pregnancy symptoms will subside, and the body will expel it naturally.

    Both medication and natural miscarriage involve heavy bleeding, similar to having your period if not heavier, nausea and cramping. Some women may still need a D&C in case not all the blood and tissue from the uterus is expelled.

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    Your chances of conceiving again after a blighted ovum

    No data says experiencing pregnancy loss due to one blighted ovum will lessen your chances of having a baby in the future.

    A 2009 study on women who had early miscarriages, including those who had a blighted ovum, showed that 80% of them went on to have a successful pregnancy and a healthy baby.

    After one blighted ovum, there is no reason to wait, and the woman can try to conceive again after she has had her first period after the miscarriage. Some doctors may advise waiting until after three months, but it mostly depends on when the woman is ready to try again after a pregnancy loss.

    Repeated incidents of miscarriage due to the blighted ovum, however, may point to an underlying issue. Your doctor may have you tested for hormonal imbalances or genetic problems.

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