The medical term for a false pregnancy, or phantom pregnancy, is pseudocyesis, from the mid-century English pseudo-meaning ‘false’ and the ancient Greek kuesis meaning ‘conception’. It is a rare condition, estimated in the US, for example, to affect only around six out of 22,000 pregnancies. It is often assumed to be ‘all in the mind’ but the reality of the condition is much more complex.

In this distressing situation, an interplay of psychological and physical factors combine to produce the phenomenon, with tangible symptoms. This makes it a completely different issue from a delusion of pregnancy which is indeed a psychotic symptom of a mental health problem in which there are no physical symptoms. In this article we explain some of the facts surrounding pseudocyesis: what the symptoms are, some possible causes and the help available.

What happens in cases of pseudocyesis?

The condition is, as is made obvious by the term false pregnancy, when someone believes that they are pregnant when in fact they are not. This is very different from the fear of being pregnant that can strike someone wishing to avoid pregnancy and whose period is late, or conversely the sometimes false hope that people experience when trying to conceive. With this condition, there are real physical symptoms of pregnancy. It is possible, although even rarer, for men to experience a phantom pregnancy. In these cases, the man’s partner is usually pregnant. The term for this is couvade and it is often referred to as sympathetic pregnancy.

What are the symptoms of a false pregnancy?

The condition is distinguished by the experience of many of the most obvious symptoms of pregnancy. These can include the cessation of periods, weight gain and a growing belly, plus frequency of urination, morning sickness and backache. A false pregnancy typically develops in the same way as a real one, beginning with the standard early symptoms like morning sickness and then developing into swollen or sore breasts, followed by a swollen belly and the appearance of being pregnant. In some cases, there is a sensation of foetal movements and even what feel like labour pains. The symptoms can continue for a period of weeks, the full nine months, or even years.

What are the causes of pseudocyesis?

Even though the condition is not solely in the mind, risk factors are at their highest for women who have experienced a high level of grief, loss or distress in connection with pregnancy experiences.

It is only quite recently that the medical profession has started to understand the complex interaction of psychological and physical phenomena that underlies pseudocyesis. Even though the exact causes are difficult to pinpoint, doctors agree that psychological factors usually somehow trick the body into believing that it is pregnant. One of the most common psychological causes is an intense desire to become pregnant, which could be caused by infertility or the approaching menopause. This in turn leads to some early pregnancy signs – like enlarged breasts – which can be interpreted by the brain as pregnancy, triggering the release of hormones like oestrogen and prolactin, which then leads to the actual pregnancy symptoms.

The fact that false pregnancy is known to occur in other mammals, not only in humans, shows that there are physical as well as psychological causes. Although the condition is usually associated with the experience of grief, depression and emotional distress, there can also be isolated physical causes which trigger symptoms. These include:

• Pelvic or abdominal tumours;
• Perimenopausal symptoms associated with the ageing process;
• Galactorrhoea, which is a milky nipple discharge that comes as a result of pituitary tumours causing the secretion of hormones;
• Elevated levels of beta-HCG (human chorionic gonadotropin), known as the pregnancy hormone, resulting from certain tumours;
• Bloating caused by medications like the oral contraceptive.

Diagnosis and treatment of a false pregnancy

Considering the complete certainty of the patient, and the fact that the hormonal balance can, as we have seen, closely mimic that of actual pregnancy, diagnosis can be difficult. However, now that the practice of ultrasound scanning has become commonplace, it is easier – and this is the only certain way to confirm the true situation.

Treatment is difficult because for a patient who may be emotionally distressed in the first place, the discovery that a pregnancy is not real can cause further distress, grief or anger. Psychological therapy and counselling will be essential, perhaps in addition to family therapy depending on the patient’s personal situation. Emotional support from the patient’s family and friends can also be an important part of the recovery process. A support system – from the patient’s partner and medical practitioner – who can treat her with care and compassion, recognising that after the denial stage, she is inevitably going to be in mourning, can help her to accept the situation and move forward in a healthy way.

Coping with signs of infertility

Pseudocyesis is thankfully very rare. But we at IVI are aware that the experience of infertility and the desire to have a child can feel overwhelming at times, even to the most well-adjusted individuals.

If you or anyone close to you have concerns about infertility, and would like to find out more about the positive action that could be taken, why not browse our website to familiarise yourself with the range of treatments that are now available. These are developing in terms of scientific knowledge and sophistication of techniques all the time. Even the best-known assisted fertility technique, in vitro fertilisation (IVF), has seen major developments such as the ICSI sperm injection technique as well as improved methods of embryo selection. You could also take a look at our video about your first IVI appointment so that you know what to expect if you decide to arrange a visit.

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