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Q. Is it possible to plan for pregnancy based on TORCH test after three miscarriages?

Answered by
Dr. Ravinder Kaur Khurana
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 26, 2019

Hello doctor,

After three miscarriages, my doctor suggested me for torch test and it came out positive with high values of rubella IgG 272, toxoplasma IgG 78.6 and CMV IgG 12.1 and herpes IgG 46.1. My doctor gave me Acylex 200 mg two times a day for two months and advised us to not try for a baby for two months. After two months medicine course, I did this test again today and again it is positive with rubella IgG 223, toxoplasma IgG 101, CMV IgG is 13.6 and herpes IgG is 47.9. We cannot understand the reports. My uterus, ovaries, hormones, everything is fine. Please tell me when we can plan a pregnancy? And what are the chances of miscarriage again because of torch test positive results? All torch test IgM values are normal.

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Hello,

Welcome to icliniq.com.

I have gone through your case summary. Please tell me about the miscarriage at what time of gestation did they occur. Have you got an ultrasound done in those previous pregnancies? Was any shadow of the baby seen at that time? Was heartbeat seen in the baby?

Next is your TORCH test. First of all, it is not responsible for recurrent miscarriages. All high values of IgG suggest that you are immune and now nothing is to be done. If we want to know a fresh infection, then only IgM or avidity testing is required. Did you have any history of fever, sore throat or any eruptions on your skin at the time of first miscarriage? Now, just do not bother about these tests.

The important test required to be done. If not done earlier are thyroid profile, fasting, and postprandial blood sugar, VDRL, anticardiolipin antibodies IgM and IgG, lupus anticoagulant, PT or INR and APTT, vitamin B12, serum homocysteine. Get all these tests and accordingly, she can plan a pregnancy after another month. Pre-conceptionally, she should take tablet Folvite 1 mg and tablet Ecosprin 75 mg once a day.


The Probable causes:

Could be anti-phospholipid antibody syndrome with bad obstetric history or hypothyroidism. deranged sugar, hyperhomocysteinemia.

Investigations to be done:

Thyroid profile, fasting and postprandial blood sugar, VDRL, anticardiolipin antibodies, IgM and IgG, lupus anticoagulant, PT or INR and APTT, vitaminB12, serum homocysteine.

Differential diagnosis:

RPL, bad obstetric history.

Treatment plan:

Tab Folvite 1 mg and tablet Ecosprin 75 mg daily. One tablet should be taken while planning the pregnancy, at least six weeks before.

Preventive measures:

First get all these tests done. If normal, then can plan pregnancy after next month.


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