The pregnancies progressed normally through the early stages: standard pregnancy tests were positive and patients' bodies began to undergo the normal changes. Jacobson performed ultrasounds, identifying a fetus in the grainy image. Around the third month, Jacobson would report that the fetus had died. In fact, these patients were never pregnant, and the bodily changes were a reaction to the hCG. The pregnancy tests were inevitably false positives because the tests determined pregnancy by the presence of hCG. During Jacobson's criminal trial, experts examined the ultrasound photographs, and reported that the purported "fetuses" were actually nearby organs or fecal matter.