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What Does My TORCH Test Report Indicate?
Question: hello Doctor,
I have previously also consulted with you regarding my second trimester miscarriage which happened at 19 weeks of gestation. The reason quoted by my treating doctor was Cervical incompetence. But then recently we carried out a series of blood tests & all the reports came normal except for the TORCH test report. I am attaching that report for your review. The doctor has now advised me Bharglob injection every 21 days for four times now. And then every 21 days for all 9 months when I conceive again.
But unfortunately this Bharglob 16.5 mg injection is not available in the city (Bangalore) where I stay.
Could you please throw some light on this Cytomagelo virus infection ? How critical is to have these injections as of now ? Also, what all precautions should I be taking when I conceive again ?
Thanks in advance for your answer. Please let me know if any other details are required from my end.
I have previously also consulted with you regarding my second trimester miscarriage which happened at 19 weeks of gestation. The reason quoted by my treating doctor was Cervical incompetence. But then recently we carried out a series of blood tests & all the reports came normal except for the TORCH test report. I am attaching that report for your review. The doctor has now advised me Bharglob injection every 21 days for four times now. And then every 21 days for all 9 months when I conceive again.
But unfortunately this Bharglob 16.5 mg injection is not available in the city (Bangalore) where I stay.
Could you please throw some light on this Cytomagelo virus infection ? How critical is to have these injections as of now ? Also, what all precautions should I be taking when I conceive again ?
Thanks in advance for your answer. Please let me know if any other details are required from my end.
Brief Answer:
No treatment is necessary.
Detailed Answer:
Dear XXXXXXX
THank you for trusting me personally with your health concern.
I have gone through the TORCH test report.
I am so sorry to say that your doctor is absolutely wrong.
There is ABSOLUTELY no need for you to take this injection.
You just have positive IgG for CMV, which indicates that you have developed immunity to this virus.
The IgM is negative, which means there is no acute infection.
NO TREATMENT is needed.
NOt now, not during pregnancy, nothing at all.
It is sad that you have been prescribed this at all.
Please discuss it with your doctor, in fact, let me have a look at the prescription
I need to check the credentials and qualifications of the doctor in the first place.
Also, in the previous discussion, I had listed out some necessary investigations for you , to be done, before planning the next pregnancy.
Have those been done ?
Looking forward to hearing form you.
Take care.
No treatment is necessary.
Detailed Answer:
Dear XXXXXXX
THank you for trusting me personally with your health concern.
I have gone through the TORCH test report.
I am so sorry to say that your doctor is absolutely wrong.
There is ABSOLUTELY no need for you to take this injection.
You just have positive IgG for CMV, which indicates that you have developed immunity to this virus.
The IgM is negative, which means there is no acute infection.
NO TREATMENT is needed.
NOt now, not during pregnancy, nothing at all.
It is sad that you have been prescribed this at all.
Please discuss it with your doctor, in fact, let me have a look at the prescription
I need to check the credentials and qualifications of the doctor in the first place.
Also, in the previous discussion, I had listed out some necessary investigations for you , to be done, before planning the next pregnancy.
Have those been done ?
Looking forward to hearing form you.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hello doctor,
Thanks for your reply. I understood what you have suggested but could this CMV be the reason for my sudden miscarriage ?
Also, how potential is this to cause any complications when I conceive again ?
Also, regarding the tests which you had prescribed the last time :
1. HSG ( XXXXXXX test of uterus and tubes ) to confirm cervical incompetence. ---- yet to be done but I had a pelvic scan done & it confirmed that the cervix is normal.
2. Karyotyping ( chromosomal testing ) of the aborted fetus was an essential investigation to rule out any genetic abnormality in the baby. I hope that was done. Karyotyping for both you and your husband also should be done. ----Unfortunately no tests were done for the aborted fetus as my doctor did not suggest any that time.
3. I also assume your blood pressure, weight, height are within normal limits. ---- Yes, these are normal.
4. Hormonal tests ( for irregular cycles ) - FSH, LH, TSH, Prolactin, OGTT ( oral glucose tolerance test to rule out diabetes ), Lipid Profile. - These tests were done & the reports are normal.
5. Testing for antiphospholipid antibodies ( important cause of miscarriage ) - APA, ACA, LAC, aPTT, ANA, Serum homocysteine. - These tests were done & reports are normal.
Thanks,
XXXX
Thanks for your reply. I understood what you have suggested but could this CMV be the reason for my sudden miscarriage ?
Also, how potential is this to cause any complications when I conceive again ?
Also, regarding the tests which you had prescribed the last time :
1. HSG ( XXXXXXX test of uterus and tubes ) to confirm cervical incompetence. ---- yet to be done but I had a pelvic scan done & it confirmed that the cervix is normal.
2. Karyotyping ( chromosomal testing ) of the aborted fetus was an essential investigation to rule out any genetic abnormality in the baby. I hope that was done. Karyotyping for both you and your husband also should be done. ----Unfortunately no tests were done for the aborted fetus as my doctor did not suggest any that time.
3. I also assume your blood pressure, weight, height are within normal limits. ---- Yes, these are normal.
4. Hormonal tests ( for irregular cycles ) - FSH, LH, TSH, Prolactin, OGTT ( oral glucose tolerance test to rule out diabetes ), Lipid Profile. - These tests were done & the reports are normal.
5. Testing for antiphospholipid antibodies ( important cause of miscarriage ) - APA, ACA, LAC, aPTT, ANA, Serum homocysteine. - These tests were done & reports are normal.
Thanks,
XXXX
Brief Answer:
Explained.
Detailed Answer:
Hello again.
Well, CMV can cause a miscarriage or an abortion as well as other side effects in the child.
But that would happen only if you had acute CMV infection during the pregnancy.
And it cannot cause a complication next time, because now you are already immune to CMV now.
A positive Ig G means you have acquired immunity to the infection.
Further, it is very less probable that the earlier miscarriage was due to CMV.
The chance of a new infection is only 1 %, and you would have showed some signs, and the baby would have shown signs and symptoms of having CMV on the ultrasound scan and also after the miscarriage.
CMV could have been tested for if your doctor suspected it in the first place.
TORCH test is not at all recommended anymore anywhere as a screening test for a miscarriage.
And the treatment is just unnecessary.
Even assuming the worst case scenario, that you had CMV due to which the first miscarriage occurred, you are now immune to it.
You have immunity, and thus no further treatment is required, and it can cause no further complication to you in future pregnancies.
Am glad all the reports are normal.
It is unfortunate that the most important test was not done - karyotyping of the aborted baby.
Dont worry, take regular folic acid supplements daily.
You can start planning for a pregnancy 6 months after the abortion.
HOpe you understood my explanation.
Let me know if I have to elaborate further.
Explained.
Detailed Answer:
Hello again.
Well, CMV can cause a miscarriage or an abortion as well as other side effects in the child.
But that would happen only if you had acute CMV infection during the pregnancy.
And it cannot cause a complication next time, because now you are already immune to CMV now.
A positive Ig G means you have acquired immunity to the infection.
Further, it is very less probable that the earlier miscarriage was due to CMV.
The chance of a new infection is only 1 %, and you would have showed some signs, and the baby would have shown signs and symptoms of having CMV on the ultrasound scan and also after the miscarriage.
CMV could have been tested for if your doctor suspected it in the first place.
TORCH test is not at all recommended anymore anywhere as a screening test for a miscarriage.
And the treatment is just unnecessary.
Even assuming the worst case scenario, that you had CMV due to which the first miscarriage occurred, you are now immune to it.
You have immunity, and thus no further treatment is required, and it can cause no further complication to you in future pregnancies.
Am glad all the reports are normal.
It is unfortunate that the most important test was not done - karyotyping of the aborted baby.
Dont worry, take regular folic acid supplements daily.
You can start planning for a pregnancy 6 months after the abortion.
HOpe you understood my explanation.
Let me know if I have to elaborate further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hello doctor,
Thank you so much for answering my questions in detail. I was really very confused & scared. I just don't want the things to be repeated again as it was really very painful both physically & mentally.
I already had the first dose of Bharglob injection (16.5 mg), 20 days back & as per the prescription 3 doses are still remaining. Is it fine if I don't take them anymore ? Hope the first dose will not harm me in anyways.
Also, I am not planning for pregnancy for next 1 year atleast. Is it ok to take contraceptive pills ? Do they have any side effects or can they affect the fertility in future ?
And many thanks again for your help. It has really helped me to come out of that confusion state.
Regards,
XXXX
Thank you so much for answering my questions in detail. I was really very confused & scared. I just don't want the things to be repeated again as it was really very painful both physically & mentally.
I already had the first dose of Bharglob injection (16.5 mg), 20 days back & as per the prescription 3 doses are still remaining. Is it fine if I don't take them anymore ? Hope the first dose will not harm me in anyways.
Also, I am not planning for pregnancy for next 1 year atleast. Is it ok to take contraceptive pills ? Do they have any side effects or can they affect the fertility in future ?
And many thanks again for your help. It has really helped me to come out of that confusion state.
Regards,
XXXX
Brief Answer:
Glad I could help.
Detailed Answer:
Dear XXXXXXX
Thank you so much for your appreciation, it boosts my morale, and keeps me motivated to carry on my work , which I love doing, because of kind and gracious patients like you !
I am frankly surprised that a qualified doctor ordered such an unnecessary test, and then scared you with these results, which are perfectly normal and fine.
I am sad about the anxiety that you had to undergo because of this issue.
Believe me, the TORCH test is no more done at reputed centres , anywhere in XXXXXXX or abroad.
You do not need ANY treatment for this repeat, if you have already taken one dose of Bharglob, fine, it wont do any harm in the long run.
But believe me, no further treatment is now required at all, no further injections are needed.
Yes, you can use oral contraceptive pills.
Most women use them, and they safely resume normal menses and normal fertility maximum within 3 months of stopping them.
Condoms also are an excellent option if your husband is okay with using them.
Some males find them difficult, SKYN from Kamasutra is an excellent product which gives you natural sensation.
Try using it once before deciding to switch to pills.
Pills do not have any major side effects, or long term fertility issues, please dont worry about that.
I am glad that my input helped to avoid unnecessary injections for you, and helped to ease your state of mind.
Since you are such an intelligent and conscious patient, please read a few links that I have attached, it will add to your knowledge about this TORCH test -
http://www.drmalpani.com/knowledge-center/infertility-testing/wasteful-infertility-tests
( Read the bit on TORCH testing )
Please discuss this with your doctor also, as many other patients might be suffering from lack of knowledge on part of your doctor.
Any time in future, please feel free to write in to me directly using the link
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Glad we interacted !
Wish you a nice day, and a great life ahead !
Glad I could help.
Detailed Answer:
Dear XXXXXXX
Thank you so much for your appreciation, it boosts my morale, and keeps me motivated to carry on my work , which I love doing, because of kind and gracious patients like you !
I am frankly surprised that a qualified doctor ordered such an unnecessary test, and then scared you with these results, which are perfectly normal and fine.
I am sad about the anxiety that you had to undergo because of this issue.
Believe me, the TORCH test is no more done at reputed centres , anywhere in XXXXXXX or abroad.
You do not need ANY treatment for this repeat, if you have already taken one dose of Bharglob, fine, it wont do any harm in the long run.
But believe me, no further treatment is now required at all, no further injections are needed.
Yes, you can use oral contraceptive pills.
Most women use them, and they safely resume normal menses and normal fertility maximum within 3 months of stopping them.
Condoms also are an excellent option if your husband is okay with using them.
Some males find them difficult, SKYN from Kamasutra is an excellent product which gives you natural sensation.
Try using it once before deciding to switch to pills.
Pills do not have any major side effects, or long term fertility issues, please dont worry about that.
I am glad that my input helped to avoid unnecessary injections for you, and helped to ease your state of mind.
Since you are such an intelligent and conscious patient, please read a few links that I have attached, it will add to your knowledge about this TORCH test -
http://www.drmalpani.com/knowledge-center/infertility-testing/wasteful-infertility-tests
( Read the bit on TORCH testing )
Please discuss this with your doctor also, as many other patients might be suffering from lack of knowledge on part of your doctor.
Any time in future, please feel free to write in to me directly using the link
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Glad we interacted !
Wish you a nice day, and a great life ahead !
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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