Rising HCG after Ectopic surgery and Large Ovary

Patient

Q: I recently had surgery for an endometrioma (4 cm on my right ovary). It was removed April 3rd and 2 weeks later, I was rushed to the ER for pain and bleeding. I found out I was pregnant and had an HCG level of 386. Two days later, my HCG went up to 781. A week later, I was again rushed to the ER for pain and bleeding and was rushed into the surgery for an ectopic in my right fallopian tube. It is now 3 weeks later. Last thursday, I was still having pain, but this time on my left side. I started bleeding more (bright red blood) and randomly took a pregnancy test which came back positive. I went to my doctor the following day (last friday) to check my HCG levels. My Dr did an ultrasound and saw that my left ovary was 2.99 cm (normal he said) and had a clear cyst in it - he said I was about to ovulate and this was normal. Today (Monday), I went back and my HCG level is higher than it was before my surgery. My left ovary is now 4.88 cm and the cyst inside it is no longer clear - it is cloudy, but has fluid around it. My doctor wants to monitor me closely and check my HCG and do another ultrasound on Wednesday. Can you offer me any advice? What could this possibly be? I have not had sex since the end of March, so it could not be another pregnancy. What is going on???

Doctor

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