Blighted ovum – the silent miscarriage?
A blighted ovum is an early pregnancy failure. Strictly speaking, it’s a miscarriage. But that’s confusing: a blighted ovum exists before any bleeding happens. More often than not, it’s spotted late or not at all. Hence the alternative name a blighted ovum is sometimes given: silent miscarriage. 1 in 2 first-trimester miscarriages are due to a blighted ovum – it’s that common.
Is blighted ovum an accurate description? No – it’s the worst-named miscarriage of all time. First, the word ‘blighted’ is biologically incorrect – it’s a cellular or chromosomal failure, not something damaged externally. Second, the ‘ovum’ (Latin for egg) is not solely to blame: it’s the egg AND sperm that don’t speak to each other. Third, a silent, or missed, miscarriage also refers to an embryo with no heartbeat. That’s not what a blighted ovum is.
A better name for a blighted ovum is anembryonic pregnancy. While the gestational sac continues to grow – often into a slightly irregular, sagging shape – the embryo does not. It’s a particularly upsetting situation for women who knew they were pregnant. Those women include fertility patients, who would have religiously done a home pregnancy test 12 to 14 days after their embryo transfer. A few weeks later, at their early ultrasound scan, they’re given the dreadful news.
But women who conceive naturally rarely have that early scan. So a blighted ovum may not be discovered till the 12-week mark. You may have had pregnancy symptoms – adding to the sense of devastation when diagnosis is made. Bleeding and cramping, a common way for an anembryonic pregnancy to end, doesn’t always happen. And a blighted ovum at 12 weeks is a more serious problem than one at seven.
So want happens after a blighted ovum is diagnosed? Patients are usually advised to let the miscarriage start naturally. Drugs are sometimes prescribed to bring on the bleed. Fertility patients will be told to stop their medication – typically estrogen and/or progesterone support. But some women will need an operation to remove the pregnancy – effectively a termination. This is more common when diagnosis is late.
For women who know or suspect they’re pregnant, naturally or via IVF, there’s a lot to be said for an early scan between weeks 6 and 8. As well as checking for a blighted ovum, the scan will pick up an ectopic pregnancy – a potentially life-threatening condition. Identifying either at this stage is easier and safer for you. Insist on an early scan. Some UK NHS doctors will refuse. Remind them of their duty of care towards you. That usually does the trick.
If you’re unlucky enough to have a blighted ovum, allow yourself time to grieve for the loss of your precious pregnancy. Don’t let anyone tell you that an early miscarriage is not as bad as a late one. It’s perfectly normal to feel devastated. You are mourning the life you created, one that has been so cruelly denied you.
Will a blighted ovum happen again? The official advice is: unlikely. But the fact remains that miscarriages can reoccur and that older women are more prone to them. Speak to you doctor. And if you’ve had IVF treatment, read our tips on reducing your chances of a miscarriage.