Pregnancy & Surgery: Understanding a Corpus Luteum Cyst

Question
Ok, so I have some weird questions. I had a positve pregnancy test on Weds, I had my first OB appt on Mon, Weds I had been having some R sided pelvic pain so they did a ultrasound and couldn't see anything in my utures but did find a "mass" on my R side, so they checked my hcg and it was 1792 so they thought I was having ectopic pregnancy and we went to surgery that night. There was no tubal pregnancy but there was a corpus luteum cyst on my R ovary. So Weds we went back to check and see what my hcg levels were doing and it was 3914, but he also checked my progesterone and it was only 1.4 what does this mean? Is it low because he took that cyst or am I having a miscarriage? What is the likelihood of me keeping this pregnancy? Has anyone else had this problem?

Answer
Dear Teresa

A raised hCG level indicates either an intrauterine or extrauterine pregnancy. Early pregnancy;whether intra or extrauterine, is detectable with transvaginal sonography in experienced hands. The 3rd possibility is a gestational trophoblastic tumor but this would have been preceeded by a term pregnancy or a miscarriage. Since you had a right mass on ultrasound which was shown to be a corpus luteum cyst, I would go with the possibility of having undiagnosed pregnancy. In fact doubling the level of hCG in 48 hours is well known to be diagnostic for pregnancy.

Therefore, I believe Follow up with transvaginal ultrasound for the next few days should allow visualization of the pregnancy sac.

Good Luck