Rubella IGG Positive, IGM Negative & CMV Positive: Understanding Torch Panel Results & Next Steps

Question
Hello Doctor,

I had 2 miss- carriages with in the gap of months. Both the pregnancy lasted for 6 weeks and 9 weeks respectively. After 2nd miscarriage doctor suggested for Torch Panel test were the Rubella IGG result was positive with 37.63 IU/ML ( ref range >=11), Rubella IGM result was Negative 0.26 ratio and CMV IGG Positive with 148.4 RU/ML and CMV IGM negative with 0.43 ratio.

After this report Doctor prescribed RUBI VAC vaccination and i have taken the same. After a year of my 2nd miscarriage we are again planning for the baby and done the Torchpanel test again the result were Rubella IGG - 44.44 iu/ml, Rubella IGM - 0.37 ration, CMV IGG - 143.11 RU/ML and CMV IGM - 0.37 ratio.

Can you please suggest that whether it is ok to go ahead with planning and there will be no problem for my Baby( like birth disorders) in future.

I have scanned the net for the information on Rubella and found it very confusing. Since your answers were in detail and explanatory sending this mail to you.

thanks for your valuable service

Srividya
India.

Answer
Hello Srividya,

Thank you for seeking me out.  In this case, there is not a lot to say in terms of detail.  Both of the new tests show that you now have an immunity to both those diseases.  IgM is the measure for immunity antibodies.  If either of those were the reason for your miscarriages, then you should be fine.  However, in 85-90% of miscarriages, the cause is due to a spontaneous genetic or chromosomal abnormality that occurs as the egg divides to form an embryo.  The new immunities won't change that risk.  It is known that miscarriages can occur in up to 40% of pregnancies naturally.

On another note, did your doctor check you and your husband for recessive genetic diseases?  Were you checked for uterine abnormalities by ultrasound and hysteroscopy or hysterosonogram?  Did you have immune testing done?  These are other tests done in patients with recurrent pregnancy loss.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf