Gestational Sac Without Embryo at 5 Weeks: What Does It Mean?

Question
Hello, I hope you can help! I went for an ultrasound on Wednesday and I believe I am 5 weeks along no more than that! I can't remember my LMP! When I was scanned the Ultrasound Dr. told me that there was a gestational sac but he doesn't see a embryo! He also said either it is too early or the baby never developed! So my questions are: At 5 weeks is it normal NOT to see the embryo, and when I go back in 2 weeks will my chances of seeing my baby be good! I understand that whatever happens I will have to deal with but the thing that is upsetting is waiting 2 weeks for any answers! I had a quanative hcg done 2x and they were rising the 1st day at 4000 and 48 hrs they were around 7500! But to my understanding the hcg levels can still rise if indeed this is an blighted ovum!!! Should I or would you consider this to be an blighted ovum in your opinion!? Thank you for your advice!

Answer
Dear Dorothy,

On the whole, blighted ova pregnancies are considered those in which the placenta (or placental parts) develop but the fetus does not. Often when small, the gestational sac cannot be distinguished from any early normal pregnancy, as there may be a yolk sac, though a fetal pole is not seen. It is not until after we would expect to see the fetal pole (the embryo can be observed and measured by about 5.5 weeks) that we can really differentiate between this problem and a normally developing pregnancy. And yes, because the hCG levels do continue to rise as the placenta develops, unfortunately almost blighted ova are not diagnosed until it is seen on ultrasound that the embryo is not developing.

For diagnosis, the sac must be of sufficient size (per established medical guidelines) that the absence of normal embryonic elements is established. Because the gestational sac size may not have been at that point yet when you were there, most doctors offer women a follow-up ultrasound 7-10 days later to make sure there either is embryonic development or not. At that next (7 week) visit, visualization of the embryo would definitely be expected.

I wish I could tell you whether I think it is or is not a blighted ovum to help you prepare one way or another. But there is just no way to know until you get in there for that next ultrasound. The best I can do is say to prepare for the worst and hope for the best. That has served me well in the past. It doesn't take away the pain IF it is bad news, but it can brace you for the shock at least. And if it is good news... all the better!!!!

I hope this has helped you and answered your question. I wish you well and apologize for the delay in answering. I have recently moved and am in a mess. :)

Brenda