Concerns About Ectopic Pregnancy, Chocolate Cysts, and Ovulation Issues - Obstetrics and Gynecology

Concerns about ectopic pregnancy, accuracy of pregnancy tests, chocolate cysts, and corpus luteum cysts?

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Six years ago, I was pregnant and underwent a medical abortion at six weeks due to financial pressures when I was younger.
After the procedure, my menstrual cycles became irregular, often with late periods and a tendency for menstruation to end quickly by the third or fourth day.
Before each normal period, I typically experienced a week of spotting with brown discharge.
During this time, I regularly visited the same obstetrics and gynecology clinic, where the doctor performed ultrasounds but did not mention any issues with my uterus or ovaries.
Last July, I suffered from depression and was prescribed antidepressants at a major hospital, which I took until early December last year, during which my menstrual cycles were quite chaotic.
Since stopping the medication in early December, my last period was on January 23, 2008, which was induced by a medication to stimulate menstruation due to high work stress.
Initially, the doctor prescribed oral medication to induce menstruation, but after a week of brown spotting, I returned to the clinic, and the doctor suggested an injection to induce menstruation, which resulted in my period starting three days later, accompanied by severe cramps.
I had previously received such injections in my teenage years, but it had been over ten years since I last used one, and while I experienced cramps during my periods, they were not as severe as this time.
I wonder if the intense cramps are related to the injection.
Last month, my period started on March 6, also induced by oral medication, as I had brown spotting since March 1 but no menstruation.
After consulting with my gynecologist and undergoing an ultrasound, I was prescribed oral medication to induce menstruation, but this period also came with severe cramps.
On March 7, I informed the doctor that I wanted to conceive and regulate my menstrual cycle.
After an ultrasound, the doctor prescribed Clomiphene, which I started taking on March 8, one tablet in the morning and one in the evening for five days.
On March 18, I returned for a vaginal ultrasound to check the follicle development.
On March 14, I underwent a hysterosalpingography, and the doctor confirmed that my fallopian tubes were open.
I was also prescribed a single dose of Cephamycin and returned on March 19 for another vaginal ultrasound.
Initially, the doctor observed many immature follicles in my right ovary, suspecting polycystic ovary syndrome (PCOS), but later saw a 1.7 cm follicle in my left ovary, concluding that it was not PCOS.
When I asked about the thickness of my endometrium, the doctor said it was normal.
However, during my appointment on March 20 to receive the ovulation trigger injection, a different doctor informed me that my endometrial thickness was too thin and suggested that I should undergo a procedure similar to a "dilation and curettage" to remove some endometrial tissue before attempting to conceive to avoid implantation issues.
The vaginal ultrasound did not indicate any ovarian cysts.
Following the doctor's instructions, I had intercourse with my husband on March 22.
On March 27, concerned about potential infertility, I consulted a fertility specialist.
After a pelvic exam, the doctor noted a hard mass in the rectouterine pouch, indicating mild to moderate endometriosis.
A subsequent vaginal ultrasound confirmed that my right ovary had a cyst, which was identified as a 1.7 cm chocolate cyst.
When I inquired about treatment, the doctor advised waiting for blood test results and returning on the second to fourth day of my next period for a hysterosalpingogram.
I mentioned that I had previously undergone a hysterosalpingography, but the fertility specialist stated that it was an outdated method and not accurate.
On the night of April 3 to the afternoon of April 4, I experienced brown spotting, which I thought was the onset of my period.
However, on April 5, the spotting stopped, and I took a home pregnancy test, which showed two lines, but the second line was very faint.
On April 6, I tested again, and the line was slightly darker.
On April 7, the line was even darker.
On April 8, I visited the fertility clinic, where the doctor confirmed my pregnancy through a urine test.
I explained the spotting from April 3 to April 4, and the doctor indicated that it was likely implantation bleeding.
However, during an abdominal ultrasound, the doctor could not detect the embryo, explaining that it might be too small to see at this stage, and scheduled a follow-up for April 16.
On the evening of April 9, I visited another obstetrics and gynecology clinic, where the doctor, based on his clinical experience, noted a 3.6 cm cyst on my right ovary, which he believed to be a corpus luteum cyst.
He reassured me that it would likely resolve by itself after 12 weeks once the placenta stabilized.
I have many concerns and have been unable to sleep due to anxiety.
I hope the doctor can patiently address my questions, and I am very grateful for the previous encouragement I received from my doctor, who assured me that I still had a chance this cycle.
1.
If the chocolate cyst is 1.7 cm, why was it not visible during the ultrasound at the obstetrics and gynecology clinic? The doctor never explained this (I have previously had cysts that resolved on their own).
2.
How could the chocolate cyst grow from 1.7 cm on March 27 to a corpus luteum cyst of 3.6 cm on April 9? (Please, experienced doctors, clarify whether it is more likely to be a chocolate cyst or a corpus luteum cyst).
3.
Is the inability to see the embryo indicative of an ectopic pregnancy? I researched ectopic pregnancy symptoms, which include abdominal pain and spotting.
While I do not have spotting, I do feel a sensation of needing to have a bowel movement.
Is this a sign of abdominal pain? I also read that a pregnancy test may not show positive until a week later in the case of ectopic pregnancy, but I tested positive on April 5 (the second line was faint), and my last period was on March 6, which is a 31-day interval.
Does this indicate an ectopic pregnancy?
4.
If it is implantation bleeding, why is there no embryo visible in the uterus?
5.
Does a 3.6 cm corpus luteum cyst indicate an ectopic pregnancy (since the embryo may have implanted in the ovary)?
6.
If I am pregnant, could this be a false positive due to the presence of the corpus luteum cyst and chocolate cyst?
7.
Could the hysterosalpingography I underwent cause pelvic inflammatory disease, leading to an ectopic pregnancy? However, when I asked my gynecologist, he said that if it were pelvic inflammatory disease, I would likely have a fever, which I do not have (I regret having undergone this test).
Given the above, could you please help me assess the likelihood of an ectopic pregnancy? I am very anxious about potentially losing this hard-won pregnancy, and I also fear that this might be a false positive or a pseudopregnancy.
I have been worried for several nights and hope for a compassionate doctor to provide answers.
Thank you!

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Danxin de wo, 30~39 year old female. Ask Date: 2008/04/10