I am 52 years old, and I have just been told I may be pregnant. My hCG blood count is elevated, and I have missed my period for the last two months. I also have just been told I have a large cyst on my ovary. My doctor took blood tests to see if I am in menopause, and the tests came back negative. Could the cyst be causing the high hCG and the missed periods? Could there be any other explanation other than pregnancy? How can I find out for sure?

Ann

It is quite unlikely, but not impossible, that you are in fact pregnant. Production of hCG -- the "pregnancy hormone" -- by the placenta begins at the time of implantation. hCG production may also be related to ovarian cysts and certain types of tumors. The most common of these is molar pregnancy, a type of placental tumor.

I am guessing that your physician performed a transvaginal ultrasound to evaluate your situation. If a pregnancy is not seen in the uterus, the presence of a cyst would suggest that the ovary may be the source of hCG. The ultrasound appearance, along with hCG levels and other tumor marker blood tests, should enable your physician to determine how likely it is that the cyst represents a potentially malignant ovarian tumor. In any case, if ultrasound testing does not confirm the presence of a normal pregnancy, your physician should discuss with you the need for surgical evaluation of the cyst.