![]() Familiars spawned this way do not count towards transformations nor the collection page.For example, negating damage with the Holy Mantle will not count. Only actually getting damage counts towards the payout.Familiars that have yet to be unlocked can spawn, with the exception of Lil Abaddon and Twisted Pair, which must be unlocked before they can spawn through Cambion Conception.Only one of each type of familiar can be spawned.Lilith can get a second Incubus through this. Lilith starts with this item by default, even if it hasn't been unlocked.Isaac will look progressively more pregnant as he takes damage.As a result, after taking damage 90 times, four out of eight possible familiars will have spawned. The third and fourth familiars will each spawn after taking damage 30 more times. The first and second familiars will each spawn after taking damage 15 times.Upon taking damage a certain number of times, Isaac gains a permanent demonic familiar.
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