Immaculate Conception is an unlockable passive item added in The Binding of Isaac: Afterbirth.
Effects
- Upon picking up enough heart pickups, Isaac gains a permanent angelic familiar and generates a Soul Heart drop. Possible familiars include:
- All five familiars will spawn in a random order, each after collecting 15 hearts.
- After all familiars have been spawned, a Soul Heart will still drop every 15 hearts collected.
- Isaac will look progressively more pregnant as he collects hearts pickups.
Notes
- All types of hearts except Gold Hearts and Blended Hearts count.
- Items that directly add health such as
Yum Heart, Book of Revelations, Satanic Bible, and The Nail do not count towards spawning a familiar. - Only one of each type of familiar can be spawned.
- This item is the angelic counterpart to Cambion Conception.
- The Lost can pick up Soul Hearts and Black Hearts despite having no health and thus can activate Immaculate Conception.
- Keeper cannot encounter hearts and thus the item is useless for him.
Interactions
- The Jar: Hearts collected in the jar do not count towards activation.
In-game Footage
Trivia
- Immaculate Conception refers to the Catholic teaching that the conception of the Virgin Mary was free from original sin.
 Lilith Unlocks
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 The Binding of Isaac: Rebirth
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