TORCH Test in Pregnancy: What the Panel Checks and How to Read IgG and IgM

TORCH is an acronym: Toxoplasmosis, Other infections (such as syphilis, HIV, parvovirus B19 or chickenpox), Rubella, Cytomegalovirus (CMV) and Herpes simplex. The panel looks for antibodies against these germs in the blood of a pregnant woman or a newborn^[1]. This guide explains how to read a TORCH report and which of these tests are really recommended in pregnancy. Each infection has its own page; for example, our guide to the toxoplasmosis blood test covers that test in depth.

What does a TORCH panel test for? A report, annotated

There is no single standard TORCH panel: each lab chooses its antibodies, usually IgG and IgM for toxoplasmosis, rubella, CMV and herpes. Syphilis, HIV and hepatitis B, screened in every pregnancy, usually appear as separate lines.

Fictitious example of a TORCH antibody report with routine prenatal infection tests (United States format)

Test	Result	Reference range	Flag
Toxoplasma IgG	< 3.0 IU/mL	Negative: < 7.2 IU/mL
Toxoplasma IgM	Negative	Negative
Rubella IgG	38 IU/mL (immune)	Immune: ≥ 10 IU/mL
CMV IgG	4.6 U/mL	Negative: < 0.6 U/mL	POS
CMV IgM	Negative	Negative
HSV-1 IgG, type-specific	Positive (index 5.1)	Negative: < 0.9	POS
HSV-2 IgG, type-specific	Negative (index 0.2)	Negative: < 0.9
RPR (syphilis)	Nonreactive	Nonreactive
HIV-1/2 antigen/antibody	Nonreactive	Nonreactive
Hepatitis B surface antigen	Nonreactive	Nonreactive

1. Two antibodies per germ: IgG shows a past contact (or a vaccine); IgM is the early antibody of a new infection. Read them as a pair. Cut-offs differ between labs.
2. Toxoplasma IgG and IgM negative: no past infection, so no protection: prevention advice matters.
3. Rubella IgG immune: protected against rubella, usually from vaccination.
4. CMV IgG positive, IgM negative: the most common pattern of a past CMV infection, before this pregnancy. "POS" here is not an alarm.
5. HSV-1 IgG positive: a past herpes simplex type 1 infection, most often cold sores.
6. Syphilis, HIV and hepatitis B nonreactive: these are the screening tests recommended for every pregnancy^[5][6][7].

Which TORCH tests are in the panel, and what does each one check?

The infections behind the TORCH acronym, the usual test and the most common result

Infection	Usual test	What it tells you	Full guide
Toxoplasmosis	Toxoplasma IgG and IgM, avidity if IgM is positive	Past infection (IgG alone) or possible recent infection; IgM can stay positive up to 18 months[10]	Toxoplasmosis IgG and IgM
Syphilis ("other")	RPR or treponemal antibody test	Screening at the first prenatal visit for everyone[5]	RPR syphilis test
HIV ("other")	HIV antigen/antibody test	Recommended for all pregnant people[7]	HIV test results
Hepatitis B ("other")	Hepatitis B surface antigen (HBsAg)	Recommended at the first prenatal visit[6]	Hepatitis B
Parvovirus B19 ("other")	Parvovirus IgG and IgM	Done after exposure or symptoms; most adults are already immune[15]	Ask your clinician
Chickenpox ("other")	Varicella IgG	Checks immunity when there is no proof of past chickenpox or vaccination[16]	Chickenpox (varicella)
Rubella	Rubella IgG	Immune or not; IgM only if a recent exposure is suspected[8]	Ask your clinician
Cytomegalovirus	CMV IgG and IgM, avidity if needed	Past or recent infection; not routinely screened in the US[13]	CMV IgG and IgM
Herpes simplex	Type-specific HSV-1 and HSV-2 IgG	Past infection; IgM is not recommended[14]	Herpes tests

Is a TORCH test recommended in pregnancy?

Not as a package. The tests that US task forces and the CDC recommend for every pregnancy are syphilis at the first prenatal visit^[5], hepatitis B at the first prenatal visit^[6] and HIV for all pregnant people^[7], plus a rubella IgG for anyone without proof of immunity^[8]. Toxoplasmosis is not on that list.

• Common Syphilis: tested for all at the first visit, and again at 28 weeks and at delivery in communities where syphilis is frequent or when the risk is higher^[5].
• Common Rubella and chickenpox immunity: checked when there is no record of immunity, because the MMR and chickenpox vaccines are not given during pregnancy^[20]; a woman without rubella immunity is vaccinated after the birth^[8].
• Possible Targeted tests: CMV, toxoplasmosis or parvovirus after an exposure, a fever, a rash or an ultrasound finding.
• Rare Not routine: routine CMV screening is not recommended in the United States^[13][12], and neither is routine HSV-2 antibody screening in pregnancy^[14].

Why the doubts about the full panel? A systematic review of 2,538 pregnancies tested after an abnormal ultrasound found 26 congenital CMV infections and no confirmed case of congenital toxoplasmosis, rubella or herpes; its authors call for retiring the reflex "TORCH" order^[2]. A 10-year hospital study found primary infections in 0.8% of women tested for fetal reasons, against 2.6% when the reason was maternal, such as fever or abnormal liver tests^[3]. Pediatric specialists also point out that the classic TORCH approach can miss syphilis, which is rising again^[4].

Policies vary by country. In England, the national program offers screening for HIV, syphilis and hepatitis B at the first appointment^[17], and rubella susceptibility screening in pregnancy ended in 2016^[18].

How do you read IgG and IgM on a TORCH panel?

The same four combinations apply to most infections on the panel. Your clinician reads them with your history and any earlier results.

IgG negative, IgM negative: never infected, not protected

No sign of a past or current infection. For rubella, it means you are not immune; an equivocal result is treated as not immune^[9], and the vaccine is offered after the birth^[8]. For toxoplasmosis or CMV, it means simple precautions are worth it: well-cooked meat, washed fruit and vegetables, and avoiding contact with young children's saliva and urine, which carry a lot of CMV^[13].

IgG positive, IgM negative: past infection or immunity

This is the most frequent result. It points to an infection or a vaccine before this pregnancy. For rubella and chickenpox, it means protection. For CMV, it is reassuring but not a guarantee: prior exposure does not rule out infection of the baby^[12]. See our guide to the IgG antibody for the general meaning of this marker.

IgG negative, IgM positive: very early infection or false alarm

IgM can come from a very recent infection, before IgG appears, but some natural IgM antibodies react with the test without any infection^[11]. The usual next step is a second sample two to three weeks later: if IgG becomes positive (seroconversion), the infection is real and recent^[12]. More on this marker in our IgM blood test guide.

IgG positive, IgM positive: when did the infection happen?

This does not prove a recent infection. Toxoplasma IgM can be detected for as long as 18 months after infection^[10]. An IgG avidity test helps date it: antibodies bind more firmly as months pass. For toxoplasmosis, a high avidity excludes an infection in the last 4 months, while a low avidity suggests a recent one without proving it^[11]. For CMV, positive IgM, positive IgG and low avidity point to a primary infection^[12]. Because these results are easy to misread, confirmation in a reference laboratory is advised for toxoplasmosis^[10].

Herpes: IgG type-specific only

HSV IgM tests are not recommended: they are not type-specific and can be positive during a recurrence^[14]. Type-specific IgG can still help identify women at risk of catching genital herpes during pregnancy, for example when a partner has it and she does not^[14].

How should you prepare for a TORCH blood test?

The TORCH panel is a simple blood draw.

• No fasting needed for antibody tests, unless other tests are drawn on the same sample.
• Bring earlier results, especially tests done before pregnancy: a negative IgG followed by a positive IgG is the clearest proof of a new infection.
• Bring your vaccination record for MMR and chickenpox; documented vaccination counts as evidence of immunity^[9][16].
• Mention recent symptoms or contacts: fever, rash, joint pain, or contact with a child who has a rash illness.

When should you see a doctor about TORCH results?

Frequently asked questions

What does a negative TORCH test mean?

It means no antibodies were found for the infections tested: no sign of a past or current infection. It also means no immunity, so for rubella the vaccine is offered after the birth^[8], and for toxoplasmosis and CMV everyday precautions matter.

Should I have a TORCH test before getting pregnant?

Checking rubella and chickenpox immunity before pregnancy is useful, because both vaccines must be given before conception: pregnancy should be avoided for 4 weeks after the MMR vaccine^[9]. Ask your clinician which other tests make sense for you.

Is a TORCH test done after a miscarriage?

Antibody panels rarely explain a single loss, but testing for syphilis is recommended after any fetal death after 20 weeks^[5].

Is a TORCH test used for newborns?

Yes, when a baby has signs of a congenital infection^[1]. For CMV, a newborn is tested by PCR on saliva, urine or blood within 2 to 3 weeks of birth, because antibody tests cannot diagnose congenital CMV^[13].

Related tests and guides

• Toxoplasmosis blood testIgG, IgM and avidity for toxoplasmosis, in detail.
• Cytomegalovirus (CMV)Symptoms, IgG/IgM reading and what CMV means in pregnancy.
• SyphilisStages, blood tests and treatment.
• Group B strep test in pregnancyThe swab done late in pregnancy and what a positive result means.
• Glucose tolerance testThe other key prenatal test, between 24 and 28 weeks.

References

1. MedlinePlus Medical Encyclopedia. TORCH screen. medlineplus.gov (accessed November 1, 2026)
2. Fitzpatrick D, Holmes NE, Hui L. A systematic review of maternal TORCH serology as a screen for suspected fetal infection. Prenat Diagn. 2022;42(1):87-96. doi:10.1002/pd.6073 (accessed November 1, 2026)
3. Abu Shqara R, Kaufman M, Or S, et al. The utility of serologic TORCH testing during pregnancy for maternal-related versus fetal-related indications: a retrospective study. Pediatr Infect Dis J. 2025;44(3):257-262. doi:10.1097/INF.0000000000004591 (accessed November 1, 2026)
4. Penner J, Hernstadt H, Burns JE, Randell P, Lyall H. Stop, think SCORTCH: rethinking the traditional 'TORCH' screen in an era of re-emerging syphilis. Arch Dis Child. 2021;106(2):117-124. doi:10.1136/archdischild-2020-318841 (accessed November 1, 2026)
5. Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021: syphilis during pregnancy. cdc.gov (accessed November 1, 2026)
6. US Preventive Services Task Force. Screening for hepatitis B virus infection in pregnant women: reaffirmation recommendation statement. JAMA. 2019;322(4):349-354. doi:10.1001/jama.2019.9365 (accessed November 1, 2026)
7. US Preventive Services Task Force. Screening for HIV infection: recommendation statement. JAMA. 2019;321(23):2326-2336. doi:10.1001/jama.2019.6587 (accessed November 1, 2026)
8. McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS. Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2013;62(RR-04):1-34. cdc.gov (accessed November 1, 2026)
9. Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book): rubella. cdc.gov (accessed November 1, 2026)
10. Centers for Disease Control and Prevention. DPDx: toxoplasmosis. cdc.gov (accessed November 1, 2026)
11. Teimouri A, Mohtasebi S, Kazemirad E, Keshavarz H. Role of Toxoplasma gondii IgG avidity testing in discriminating between acute and chronic toxoplasmosis in pregnancy. J Clin Microbiol. 2020;58(9):e00505-20. doi:10.1128/JCM.00505-20 (accessed November 1, 2026)
12. Society for Maternal-Fetal Medicine; Hughes BL, Gyamfi-Bannerman C. Diagnosis and antenatal management of congenital cytomegalovirus infection. Am J Obstet Gynecol. 2016;214(6):B5-B11. doi:10.1016/j.ajog.2016.02.042 (accessed November 1, 2026)
13. Centers for Disease Control and Prevention. Clinical overview of cytomegalovirus (CMV). cdc.gov (accessed November 1, 2026)
14. Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021: genital herpes. cdc.gov (accessed November 1, 2026)
15. Centers for Disease Control and Prevention. Parvovirus B19 in pregnancy. cdc.gov (accessed November 1, 2026)
16. Centers for Disease Control and Prevention. Clinical overview of chickenpox (varicella). cdc.gov (accessed November 1, 2026)
17. National Institute for Health and Care Excellence. Antenatal care (NG201), recommendation 1.2.13. 2021. nice.org.uk (accessed November 1, 2026)
18. Public Health England. Rubella susceptibility screening in pregnancy to end in England. 2016. gov.uk (accessed November 1, 2026)
19. US Preventive Services Task Force. Screening for syphilis infection in pregnant women: reaffirmation recommendation statement. JAMA. 2018;320(9):911-917. doi:10.1001/jama.2018.11785 (accessed November 1, 2026)
20. Centers for Disease Control and Prevention. Guidelines for vaccinating pregnant women. cdc.gov (accessed November 1, 2026)

This article is general health information. It does not replace a medical examination, diagnosis or treatment. During pregnancy, with heavy bleeding, severe pain or fever with confusion, seek emergency care without waiting.