Charlotte (pictured) and her current husband were told that the pregnancy was ectopic – instead of growing inside the womb, the fertilized egg had lodged in one of her fallopian tubes
The young filmmaker Charlotte Carroll went to the hospital in pain and was convinced she had a hernia. But while she was waiting in the car, she received surprising news.
“I was told I was pregnant,” says Charlotte, 29.
“I was shocked when I didn’t try.”
But the joy of the “amazing news” for Charlotte and her current husband, Diego Bivero-Volpe, an entrepreneur, was short-lived.
An hour later, they were told that the pregnancy was ectopic – instead of growing inside the womb, the fertilized egg had lodged in one of their fallopian tubes.
An ectopic pregnancy is never viable and can be fatal to a woman as the tube can rupture as the developing baby grows, causing dramatic blood loss.
“A nurse told me I was eight weeks pregnant and that most likely they would have to remove the embryo along with the fallopian tube,” says Charlotte, who lives in south-west London with Diego, formerly TV’s Made In Chelsea.
“I burst into tears and said,” So how am I ever going to have a baby again? “It was such a sad moment. ‘
Little did Charlotte realize that the abdominal pain and vaginal bleeding she was experiencing were classic warning signs of an ectopic pregnancy.
Little did she know that the fact that she had endometriosis – where cells similar to those in the lining of the uterus are found elsewhere in the body – doubled her risk of an ectopic pregnancy.
These cells can grow anywhere, including in the pelvis, around the bladder, and even in the lungs, causing severe pain. The tissues swell and bleed like the lining of the uterus every month, but the blood has nowhere to go. Charlotte was 25 when she was told she had endometriosis.
“I learned that 50 percent of women had fertility problems, but I didn’t know that they were more likely to have an ectopic pregnancy,” she says.
She is now telling her story to give hope to others that she is pregnant again – “accidentally like before” – and her baby will be born this month. It comes as a surprise as having only one fallopian tube can reduce the likelihood of pregnancy, as can endometriosis
Why it increases this risk is unclear.
“We know the connection, but we can’t explain the mechanism,” says Andrew Horne, Professor of Gynecology and Reproductive Medicine at Edinburgh University.
11,000 ectopic pregnancies are diagnosed in the UK each year. Sometimes an ectopic pregnancy can be implanted in the spleen, intestines, or an old cesarean scar, but 95 percent are embedded in one of the fallopian tubes.
Charlotte, who has starred in films like Burnt with Bradley Cooper and won awards for her 2017 film Red Crayon, decided to put the camera on herself while she was hospitalized for her ectopic pregnancy in August 2019.
“What happened was so incredible and traumatic that I thought maybe I wouldn’t remember,” she says. She has now turned the footage into a powerful short film, The Topic.
“I wanted women to know that they are not alone,” she says.
During her two-day stay at Chelsea and Westminster Hospital in London, the embryo and fallopian tube in which it was implanted had to be removed via laparoscopy. This is the case when a tube with a camera on the end is inserted through a small incision in the abdomen.
The whole experience made her feel “destroyed” and wondered if she should “freeze my balls or call adoption agencies”.
She is now telling her story to give hope to others that she is pregnant again – “accidentally like before” – and her baby will be born this month.
It comes as a surprise as having only one fallopian tube can reduce the likelihood of pregnancy, as can endometriosis.
“One-third to one-half of women with endometriosis will have trouble getting pregnant,” says Professor Horne.
Charlotte’s happiness mixed with fear when she found out she was pregnant again. “I couldn’t relax until I had an early pregnancy scan and it was confirmed that it was in the right place,” she says
“Endometriosis can cause problems by changing the environment in the pelvis and making it more inflammatory, so the pregnancy will not implant properly or the egg quality may not be as good.”
At least 1.5 million women in the UK have the disease – although the charity Endometriosis UK believes the real number may be higher as awareness remains low and women are embarrassed to seek help with symptoms such as heavy periods .
Women experience symptoms an average of eight years before diagnosis – partly because diagnosing endometriosis can be difficult, says Professor Horne.
‘Many of the symptoms intersect with other conditions, such as irritable bowel syndrome [painful stomach cramps and bloating] or painful bladder syndrome, which can mimic the pain in the bladder found in women with endometriosis, ”he says.
Charlotte lost the count of how often she went to her family doctor and was told that she was simply having painful periods.
“I took the birth control pill at 15 and felt it was time to get off at 20,” she says.
“I didn’t know then, but the pill suppresses the symptoms of endometriosis because it inhibits ovulation and stops the lining of the uterus from growing and shedding.
“When I got off the pill, my periods became so painful that I couldn’t manage them. It was impossible to get up or talk.
“My GP gave me strong prescription pain relievers like diclofenac, but she never mentioned endometriosis. She just said I had painful periods.
‘The pain would start 12 hours before your period. It felt like barbed wire and made me sick. ‘
When Charlotte was 23, her family doctor referred her to a gynecologist who eventually performed a laparoscopy. Areas of the endometrial tissue were found on the left side of her abdomen that had been lasered away.
“It was a relief to know what was going on, but I felt silly, even angry, that it hadn’t been treated before,” says Charlotte.
“I never had any of the classic symptoms like pain during sex or bowel movements, but after surgery the pain stopped during my period.”
However, three years later, in 2019, the pain returned.
Laparoscopy is the most common way to diagnose endometriosis, and while the tissue is often excised during the procedure, it usually occurs again.
“In 20 percent of women the symptoms recur within two years and in 50 percent within five years,” says Professor Horne. Female hormones stimulate endometrial tissue regrowth.
This month, Professor Horne is starting a study of 400 women undergoing laparoscopy to determine whether it is better to remove the tissue at the same time or opt for medical management instead.
Typically, hormonal drugs such as the combined birth control pill are used to treat the disease, but these are not suitable for women trying to get pregnant.
In the meantime, work is being done to understand the cause of endometriosis. “The theory we are working on in Edinburgh is based on retrograde menstruation,” says Professor Horne.
This happens when menstrual blood, which contains endometrial cells, flows back into the pelvis through the fallopian tubes instead of leaving the body. This happens in 80 to 90 percent of endometriosis patients. So we investigated why in some the tissue appears to be adhering to the lining of the uterus as it should, but in others it does not. ‘
Professor Jason Abbott, a gynecologist and obstetrician at the University of New South Wales in Australia, believes some cases are caused by “pain syndrome,” where the brain learns to experience pain even after the tissue has been removed.
Charlotte’s happiness mixed with fear when she found out she was pregnant again.
“I couldn’t relax until I had an early pregnancy scan and it was confirmed that it was in the right place,” she says.
“I want to give hope to other women struggling with endometriosis, who will see that a successful pregnancy is possible.”
You can see Charlotte’s film on thetopic.co.uk
The bacteria in your gut are connected to more than you think
This week: Alzheimer’s disease
People with Alzheimer’s have a different mix of gut bacteria, and now scientists from Italy and Switzerland may have identified the importance of this.
By comparing brain scans and blood samples, they found that patients with this disease had high levels of proteins produced by certain gut bacteria.
In addition, Alzheimer’s is characterized by amyloid plaques in the brain, and the study published in the Journal of Alzheimer Disease showed that people with the largest plaques had the highest levels of these proteins.
“This research appears to suggest that abnormalities in gut microbiota activity contribute to the development of amyloid plaques in Alzheimer’s patients,” said Lynne Barker, associate professor of cognitive neuroscience at Sheffield Hallam University.
“It is well known that the gut and the brain are closely related. We are beginning to learn about the functions of the microbial community in our gut.”