TPPA testing is a diagnostic test for syphilis, used in cases of infertility. Typically, general hospitals do not include syphilis testing. If there is a high risk of syphilis, such as if either partner has a history of unprotected sexual intercourse, or if syphilis is suspected during pre-marital, prenatal, or pre-pregnancy examinations finding TP positive, a request can be made for TPPA testing. Diagnosis of syphilis requires both TPPA and RPR titers; the condition is assessed based on these two indicators.