Everything looked perfect.
A top-grade embryo. A smooth transfer. Rising HCG levels. All signs pointed to a promising pregnancy.
But then came the first ultrasound.
No fetal pole. No heartbeat. Just an empty gestational sac.
This experience is heartbreaking—and more common than many realize. Even when conditions appear ideal, an empty gestational sac, or blighted ovum, can still occur. If you’re an intended parent going through this now, please know: you’re not alone. And there is still hope.
💬 A Real Case From Ivy Surrogacy
We once supported a surrogate who had transferred a beautiful, PGT-A tested euploid embryo. Her bloodwork looked perfect—rising HCG levels, typical early pregnancy symptoms, and no red flags.
But at 6 weeks, the ultrasound showed no fetal development. No yolk sac. No heartbeat. Just an empty gestational sac.
We waited one more week and repeated the scan, hoping perhaps it had been too early. Unfortunately, the result was the same: a blighted ovum.
Understandably, both the surrogate and the intended parents were devastated. She underwent a D&C procedure and took time to heal emotionally and physically.
Later, we moved forward with another PGT-A tested embryo.
This time, it worked. A healthy baby was born.
🧬 What Is a Blighted Ovum (Empty Gestational Sac)?
A blighted ovum is a form of early pregnancy loss. It occurs when a fertilized egg implants in the uterus and begins forming a gestational sac—but the embryo either fails to develop or stops growing very early.
Pregnancy hormone levels (like HCG) may continue to rise temporarily, and the uterus may appear pregnant, even though no embryo is forming inside the sac.
❓ Why Can This Happen—Even After PGT-A?
This is one of the most difficult and confusing realities for intended parents. After investing in genetic screening, many assume the risk of miscarriage is eliminated—but unfortunately, that’s not the case.
While PGT-A (Preimplantation Genetic Testing for Aneuploidy) helps reduce the chance of chromosomal issues by screening for both numerical abnormalities and major structural problems, it does not cover everything. Here’s what it doesn’t detect:
- Minor structural abnormalities not large enough to be picked up by the test
- Issues during early cell division that occur post-transfer
- Mitochondrial dysfunctions or epigenetic errors, which are not visible in PGT-A results
- Random developmental anomalies that can occur even in seemingly perfect embryos
In short, even a chromosomally normal embryo can fail to develop due to unpredictable biological factors.
🤝 It’s Not Your Fault—Or Your Surrogate’s
This is perhaps the most important message:
This is not your fault. And it’s not your surrogate’s fault either.
Pregnancy is an extraordinarily complex process. When a blighted ovum occurs, it is almost always due to genetic or developmental issues beyond anyone’s control. No change in behavior, no level of emotional preparedness, and no medical treatment could have changed the outcome.
🏥 What Happens After the Diagnosis?
If an ultrasound confirms an empty gestational sac (typically when the sac exceeds 25mm and lacks a yolk sac or embryo), your doctor may offer the following options:
- Expectant management – waiting for a natural miscarriage
- Medical management – using medication to induce miscarriage
- Surgical management – a D&C (dilation and curettage) to safely remove tissue
Each situation is unique. Your fertility team will help you choose the best path for you and your surrogate.
🌱 Moving Forward—With Hope
This kind of loss is painful—but it does not mean the journey ends here.
As our real-life story shows, it is entirely possible to try again—and succeed. Many intended parents who experience a blighted ovum on one transfer go on to have a healthy baby with another embryo.
At Ivy Surrogacy, we’ve walked alongside families through these difficult chapters—and celebrated with them when joy returned.
❓FAQ: Blighted Ovum After PGT-A Embryo Transfer
1. Does PGT-A eliminate the risk of a blighted ovum?
No. While PGT-A significantly reduces the risk of chromosomal abnormalities, it does not eliminate the possibility of early pregnancy loss. Developmental issues, mitochondrial problems, or post-transfer cell division errors can still lead to a blighted ovum.
2. How common is a blighted ovum in IVF or surrogacy?
A blighted ovum is one of the most common causes of miscarriage, accounting for nearly 50% of early pregnancy losses in the first trimester. Even with IVF and PGT-A tested embryos, it can still occur in some cases.
3. What are the signs of a blighted ovum?
Often, there are no clear symptoms beyond those of a normal early pregnancy. HCG levels may continue to rise, and pregnancy symptoms may persist. The diagnosis is usually made during the first ultrasound when no yolk sac or embryo is visible inside the gestational sac.
4. Can you try again after a blighted ovum?
Yes. Most intended parents who experience a blighted ovum go on to have successful pregnancies with another embryo. Your doctor will guide you on the timing of the next transfer, depending on whether medical or surgical management was needed.
5. Is a blighted ovum anyone’s fault?
No. A blighted ovum is almost always due to biological or genetic factors beyond anyone’s control. Neither the surrogate’s lifestyle nor the intended parents’ actions caused it.
6. What is the treatment for a blighted ovum?
Options include:
- Expectant management (waiting for a natural miscarriage)
- Medical management (medications to induce miscarriage)
- Surgical management (D&C procedure)
Your fertility doctor will help determine the safest and most appropriate approach.
💚 Final Thoughts
An empty gestational sac after a PGT-A embryo transfer is a heartbreaking detour—but not the end of the road.
It’s a reminder of how intricate and unpredictable reproduction can be. But it’s also proof that hope is still alive.
If you’re navigating a similar experience, we’re here to support you—with compassion, clarity, and decades of combined medical expertise.
💬 Reach out to our team—we’re ready to walk with you toward your next step.
