Monday, February 25, 2008

Dr Linda blamed herself for her miscarriages but she was a victim of hormones

Photo by balmed herself for her miscarriages
When TV psychologist Linda Papadopoulos looked into her newborn daughter's eyes, she was overwhelmed with happiness.

"I stared at her face and tiny fingers and toes in awe," she recalls five years later, beaming with the joy of that memory.

It's a happiness tinged with the misery of five miscarriages and an ectopic pregnancy - and the knowledge that she is unlikely to have another child.

Linda, 36, has polycystic ovaries, a condition that causes a hormonal imbalance that increases the risk of miscarriage by up to 65 per cent. It's estimated that up to 25 per cent of women of childbearing age have polycystic ovaries, yet often do not know it.

Indeed, Linda wasn't diagnosed until after her third miscarriage.

There was no hint of a problem when the psychologist, best known for her insights on Celebrity Fit Club and Big Brother, married in 1998.

She and her husband Teddy Pitsillides, a London-based investment banker, both wanted to start a family quickly and planned on having several children.

A year into married life Linda became pregnant. "We found out just before a trip to Rome to celebrate our first anniversary," she recalls.

"I was unbelievably excited, as was Teddy. I never for a moment considered the baby might not survive. Then, to my horror, while we were away I had some spotting of blood. I hadn't felt any pain but immediately phoned my doctor in London, who told me not to worry and to come and see him as soon as I returned."

Back in the UK her doctor confirmed her worst fears. She had suffered a miscarriage at six weeks.

"I'm sure the pregnancy hormones had kicked in even at that early stage as I found the loss very traumatic. I blamed myself for flying, even for eating pizza. But the doctor assured me it wasn't my fault."

Around a quarter of all pregnancies end in miscarriage. Eighty per cent occur during the first 12 weeks of pregnancy. In most cases a faulty chromosome is to blame, causing a genetic problem that prevents the foetus surviving.

Most women then go on to have a healthy pregnancy next time. But 1 to 2 per cent of women suffer recurrent miscarriages - three or more consecutive losses - which can be a sign of an underlying problem.

A few months later Linda fell pregnant again. "I told only my parents and my best friend, so as not to tempt fate," she says.

"Instead of looking at pregnancy websites I scoured miscarriage sites to find out what the odds were of losing a second baby.

"It was scary to find that miscarrying twice is so common that doctors don't check you over to find a reason until you have lost a third baby.

"I questioned whether my mother's history of miscarriages - she had suffered two, as well as an ectopic pregnancy - made me genetically more prone to miscarriage. But my doctor reassured me it didn't and said miscarriage was not my fault.

"Nevertheless, I cut out alcohol and caffeine and even cleared out my handbag so I wasn't carrying any excess weight around. But I was terrified every time I went to the toilet in case I saw blood."

Unfortunately, she did spot blood at six weeks and suffered a second miscarriage. Her GP said her second loss wouldn't be investigated as there was still a good chance she could have a successful pregnancy. Linda wasn't satisfied and booked to see a private gynaecologist but before she could see him, she miscarried again within just a few weeks.

Blood tests revealed her problem was polycystic ovaries - her ovaries had developed many tiny cysts, fluid-filled sacs that contained unreleased eggs.

Just under half of all women with recurrent early miscarriages have polycystic ovaries. Women with the condition are able to become pregnant without a problem - the difficulties arise as the pregnancy progresses and the hormonal imbalance caused by the condition makes it impossible for the foetus to develop normally, leading to miscarriage.

It's not known what causes polycystic ovaries. There is a genetic link, although this was not the case for Linda.

But the problem had gone undiagnosed because she didn't have full-blown polycystic ovarian syndrome (PCOS), with its tell-tale symptoms such as weight gain, poor skin, increased facial hair and erratic periods (the syndrome affects between 5 and 10 per cent of women and is a leading cause of infertility).

"I was strangely pleased by the diagnosis because it explained what was wrong," says Linda.

She was put on the fertility drug Clomid to regulate her hormones. Clomid is one of the best treatments for polycystic ovaries. It forces the body to create more of the hormones that stimulate ovulation, as well as regulating pregnancy hormones vital to the embryo in the crucial early weeks.

Linda became pregnant in the first month of treatment. "Because of the Clomid I felt very positive about the pregnancy. A scan at six weeks showed the baby's heartbeat and I was overjoyed. I'd never had the privilege of seeing that before."

Even some minor blood spotting at 12 weeks didn't dent Linda's confidence. Doctors assured her that spotting at that stage is due to the formation of the placenta and is common.

"After each scan I grew more confident and I walked around pushing my tummy out as I couldn't wait for people to notice," she says.

"I found out at about 14 weeks that I was having a girl. When the first person said to me: 'When's it due?' I was five months pregnant and could have cried with joy."

The pregnancy ran smoothly and Linda elected to have Jessica by Caesarean section, feeling she'd been through enough already without the uncertainties of a natural birth.

"The birth was perfect," she says.

"I will never forget those first precious seconds of looking into Jessica's eyes and thinking: 'My God! She's just so gorgeous.' I couldn't believe I was finally a mother after everything I'd been though."

In 2004, when Jessica was two, Linda became pregnant again. With Clomid balancing her hormones, she felt confident she wouldn't suffer another miscarriage.

But spotting at 12 weeks turned out to be an ectopic pregnancy which had damaged one of her fallopian tubes. She would need keyhole surgery to remove it.

In an ectopic pregnancy, a fertilised egg implants itself outside the uterus - usually in one of the fallopian tubes - and is extremely unlikely to survive.

As the foetus grows, the tube stretches and eventually bursts, which can be life-threatening for the mother.

"I didn't ever think: 'Why me?'" says Linda. "I was just grateful I still had my health and, most importantly, I had Jessica."

Work was Linda's therapy and, once she had recovered, she went on to film Celebrity Fit Club as originally planned.

"Teddy and I agreed we'd like to have another try at some point but we didn't dwell on our disappointment," she says.

Sadly, Linda went on to miscarry two further times, once when she was three months pregnant and while taking Clomid. That time there had been a genetic problem with the baby and it died.

This had nothing to do with Linda's polycystic ovaries and was sheer misfortune.

"It was a big gym shock," says Linda. "I'd seen the heartbeat on several scans, which usually means the pregnancy is progressing well.

"In fact, Teddy didn't even come with me for the 12-week scan as we had no worries whatsoever. My best friend came instead and we giggled excitedly as I got ready to be scanned."

But Linda was unprepared for the heartbreaking news that was to follow: "Minutes later, she was holding my hand as I sat in shock, dealing with the crushing news that there was no heartbeat.

"The nurse told me that the baby was dead. I phoned Teddy and he rushed over. It was the lowest point of our marriage.

"I had an operation the following day to remove the baby and I started to think more clearly about what we'd been through. I don't want to try again, I simply want to concentrate on making the most of having Jessica.

"I don't want to put my family through any more heartache. There have been days when I've picked over whether any of the miscarriages were preventable, and wondered: 'What if?' But I have to remind myself I couldn't have done anything to change what has happened.

"I have accepted I'm unlikely to have another child, and I'm finally fine about it."


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