What this test measures
IgM and IgG antibodies for the four classical TORCH infections — each can cross the placenta and cause congenital malformations or fetal loss. The "8" reflects 4 organisms × 2 antibody classes. IgM suggests recent / acute infection; IgG indicates past exposure or immunity.
Why it matters
TORCH infections are important in Indian antenatal care because of high seroprevalence (CMV ~80–90% IgG positive by adulthood), rubella vaccination only recently added to universal immunisation (UIP from 2017), and risk of congenital infection. Routine screening of asymptomatic pregnant women is debated — global guidelines (RCOG, ACOG) recommend NOT routinely screening for TORCH in asymptomatic women because most positive IgM is non-specific or past, and few interventions exist. Common Indian practice still includes the panel especially for recurrent pregnancy loss, IUGR, suspicious ultrasound findings, or maternal symptoms.
How to prepare
No fasting required. Disclose pregnancy stage, immune status, vaccination history (MMR), any recent infections, fever, rash, contact with sick children, cat ownership / uncooked meat exposure (toxoplasma), recent travel.
Markers & reference ranges
Reference ranges below are typical adult values. Your lab's reported range may differ slightly based on the assay platform and patient demographics — always read your report against the range printed on it.
| Marker | Normal range | If low | If high |
|---|---|---|---|
| Toxoplasma IgM (reactive / non-reactive) | Non-reactive | Negative — no recent toxoplasma. | Positive — possible recent infection. Confirm with IgG avidity (high avidity = past, low = recent). Persistent IgM (> 12 months) is common and not always acute. |
| Toxoplasma IgG (IU/mL) | Negative: < 7 | Negative — no past toxo exposure; susceptible — counsel about avoiding raw meat, cat litter. | Positive — past infection or recent (need IgM + avidity to distinguish). |
| Rubella IgM (reactive / non-reactive) | Non-reactive | Negative. | Positive — possible recent rubella; in pregnancy, risk of congenital rubella syndrome. Confirm with PCR / avidity. |
| Rubella IgG (IU/mL)[1] | > 10 IU/mL = immune | < 10 IU/mL — non-immune; counsel and recommend MMR vaccination (post-partum, as MMR is contraindicated in pregnancy). | > 10 IU/mL — immune (past infection or vaccination). |
| CMV IgM (reactive / non-reactive) | Non-reactive | Negative. | Positive — possible recent CMV; confirm IgG seroconversion / avidity. Primary maternal CMV in pregnancy → ~30% fetal transmission. |
| CMV IgG (AU/mL) | Reactive (most adults positive) | Negative — susceptible; primary infection risk in pregnancy. | Positive — past CMV infection. Reactivation in pregnancy is possible but lower-risk than primary. |
| HSV-1 / HSV-2 IgG (reactive / non-reactive) | Non-reactive | Negative — susceptible. | Positive — past infection. Active genital ulcers should be PCR-tested. |
TORCH antenatal interpretation
| Marker | IgM | IgG | Action |
|---|---|---|---|
| Non-immune to rubella | Neg | Neg | Post-partum MMR vaccination |
| Past toxoplasma | Neg | Pos | No action; immune |
| Possible acute toxoplasma | Pos | Pos low avidity | Confirm; treat (spiramycin if first half pregnancy) |
| Possible acute CMV | Pos | Pos low avidity | Confirm; counsel on fetal risk; PCR if needed |
| Past HSV-1 / 2 | Neg | Pos | Manage active lesions; suppression at term |
Frequently asked questions
Should every pregnant woman get a TORCH panel?
Global guidelines (RCOG, ACOG) say no — routine TORCH in asymptomatic women generates many false-positive IgMs and causes anxiety without benefit. Targeted testing for symptoms, abnormal ultrasound, or recurrent loss is preferred. Indian practice often still uses the panel.
Why does CMV matter so much in India?
CMV is the commonest congenital infection causing sensorineural hearing loss and neurodevelopmental delay. Most Indian women are already IgG positive (past infection), but primary infection during pregnancy carries 30% transmission risk and 20% of those have long-term sequelae.
My toxoplasma IgM is positive — am I infected?
Not necessarily. Toxoplasma IgM can persist for months to years after primary infection or be a false positive. IgG avidity (high = old, low = recent) helps distinguish. PCR of amniotic fluid is definitive if congenital risk is high.
Is HSV-2 IgG dangerous in pregnancy?
Past infection is generally safe with normal vaginal delivery (low transmission risk). Active genital lesions at delivery warrant caesarean section. Suppressive aciclovir from 36 weeks reduces lesion recurrence.
Should my partner be tested?
In recurrent pregnancy loss workup, partner CMV / HSV serology can identify primary infection risk for the pregnant woman. Discuss with your obstetrician.
Do I need MMR vaccination if rubella IgG is negative?
Yes — but POST-PARTUM. MMR is a live vaccine and contraindicated in pregnancy. Avoid pregnancy for 1 month after MMR.
Related Immunology tests
Tests commonly ordered alongside TORCH Profile 8, IgM & IgG, or that help interpret an unexpected result.
Sources & references
- RCOG — Antenatal Infection Screening · accessed 2026-05-30T00:00:00.000Z
- CDC — TORCH Infections · accessed 2026-05-30T00:00:00.000Z
- ICMR — Antenatal Care Guidelines · accessed 2026-05-30T00:00:00.000Z
- FOGSI — Antenatal Screening · accessed 2026-05-30T00:00:00.000Z
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