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God help the babies! Or, absent God, a fertility startup called Orchid. It offers prospective parents a fantastical choice: Have a regular baby or have an Orchid baby. A regular baby might grow up and get cancer. Or be born with a severe intellectual disability. Or go blind. Or become obese. A regular baby might not even make it to childbirth. Any of those things could still happen to an Orchid baby, yes, but the risk, says 29-year-old Noor Siddiqui, plummets if you choose her method. It’s often called “genetic enhancement.”
Whenever I bring up Orchid in polite company, people squirm. “I’m uncomfortable,” they say. “Not for me.” “So unnatural.” Inevitably, Nazis get mentioned, as does a related word that starts with “eu” and ends in “genics.” (Orchid prefers I not utter it.) One new mom I was talking to was particularly, headshakingly disturbed. Then, a few minutes later, in an attempt to change the subject, she announced to the room that she’d just fed her 6-month-old his first peanut, and that in three months’ time she’d be feeding him his first shrimp, because that’s what the science says she must do to protect him from developing allergies.
Which is, of course, the entirety of Siddiqui’s pitch: to—based on what the science says—protect future people from future suffering. It’s why, as a teenage Thiel Fellow, Siddiqui launched a medical startup; and why, at 25, she started Orchid. It’s also why, now that the company’s gene-enhancing product is available, she wanted to be one of its first customers.
Siddiqui and her husband are perfectly fertile, but for this kind of intervention to work, you need embryos. So in 2022, Siddiqui underwent IVF at Stanford, wound up with 16 contenders, and sent off representative slivers to Orchid’s lab in North Carolina. Typically, preimplantation testing scans only for alarming abnormalities, and then a doctor selects the nicest looker. This is not that. This is something that, as Siddiqui tells me, “has been on society’s mind—sci-fi’s mind—for a generation”: a first-of-its-kind picture of every baby-to-be’s genetic destiny. Right now, Orchid calculates each embryo’s likelihood of one day suffering from any number of the more than 1,200 diseases and conditions about which we currently have (anywhere from rock-solid to, ya know, vague and extrapolative) genetic information. Who knows what it will calculate in the future.
Orchid is still in its early days—16 employees, $12 million in funding. But already they’re in 40 IVF clinics across the country and have thousands of customers. This includes, I’m told, several big-name figures in tech. Asked to betray their identities, Siddiqui scoffs, but she’s more than happy to show me the data on her own embryos. This she does on a picture-perfect day outside a coffee shop near her home in the Mission district of San Francisco. The report, which she pulls up on her laptop, is sleekly designed, with all sorts of charts and numbers, some in black (solid odds against schizophrenia), others in red (not so good for breast cancer). If it were up to Siddiqui, a Stanford-trained computer scientist, that’s all we’d talk about—the percentages, the percentiles, the “penetrances.” But I keep trying to pull her away from the numbers, from what the science (she claims) says. Because that’s not the whole story. Because, as she said herself, this is a science fiction story too …
Jason Kehe: Before we get to your embryos, I just learned that you have a new podcast—not just about Orchid but about all kinds of crazy science and future-y stuff. Should I be listening to it?
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Noor Siddiqui: Oh, definitely. The guests on it have been amazing. Do you know the writer Tim Urban? I love that guy. He’s totally changed my conception of time. You’ve seen his Life Calendar stuff, right?
Have I?
Basically he just shows you how you’ve spent 90 percent of the hours you’re ever going to spend with your parents by the time you’re 18—and how, yeah, the moments that we have with each other are actually way more scarce and nonrenewable. It's made me savor and appreciate a lot of those moments more, and be a little bit more present.
This reminds me of Orchid’s origin story, which involves your mom. Because of a genetic reason—
A condition called retinitis pigmentosa, uh huh.
Yes, she went blind.
She’s not fully blind, but she’s been legally blind for a while.
Which is one of the reasons you started Orchid, yes. But whenever I think about this story, I think—if Orchid technology had existed back then, and if the batch of embryos that contained your future mom had been screened, and if her parents—your grandparents—had not wanted their child to grow up with retinitis pigmentosa, and if they had therefore picked a different embryo and had a different child, then you—the discarded embryo’s future daughter—would not exist. Right? Do you think about that? Is that a fair line of thinking?
I sort of understand it, but I sort of don’t.
I mean, I’m sure other people have pointed this out.
They have. It’s just that, I mean, I’m not deleting my mom.
But, sort of retroactively, there is a world where you would, kind of, have deleted her.
I guess, but—the way I would think about it is, like, I would have a mom, but my mom wouldn’t have suffered in the way that she did. My mom wouldn’t have had to go blind. I wouldn’t have had to see her suffer from that.
You wouldn’t have had to see her suffer because—not to be a broken record here—you wouldn’t exist.
It would be a different version of me.
Your mom’s probably a wonderful—well, I don’t know anything about your mom.
No, she is. She’s amazing. Yes. And she would rather have vision.
And maybe the world would be better off without adult-onset blindness. Or without babies with birth defects or pediatric cancers. Yes. But oftentimes, these people go on living—and live not only meaningful lives, but world-changing lives.
Yeah. Of course.
So who’s to say that, by eliminating these conditions, we’re not eliminating the kind of person who would then go on to, for instance, want to make the world better?
The entire history of human existence is reducing suffering and making it so that more people get to participate more fully in society. Right? And secondly, we have this population of very vulnerable people who have diseases that run in their family. They’re just told, well, roll the dice and hope for the best. South Asians, for instance, have really high rates of heart attacks and diabetes. Like, that sucks. I think that’s really unfair.
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But again, you think that’s unfair because of who your mom is. Because she suffers. Something about her suffering catalyzed in you the desire to end suffering in other people. Does that make sense?
No, that doesn’t make sense. Unfortunately, not all disease is genetic. There will still be disease and suffering. We are not that much of an optimistic fantasy. We are taking risk off of the table. For the whole category of cancer, for example, about 10 percent to 15 percent has a genetic component. So 90 percent of people will still get cancer. And the same with neurodevelopmental disorders and birth defects. It’s just going to make it so that more parents can feel more confident and have more information going into the most important decision of their life, which is to have a child.
What are the diseases prospective parents seem to be most concerned about?
Pediatric and adult-onset cancers, birth defects, and neurodevelopmental disorders.
Do these tend to be controlled by the interaction of multiple genes—be “polygenic,” as you’d say?
These are all monogenic.
Cancer is only tied to a single gene?
Yeah, well, OK, that’s actually a great point. Because cancer is both monogenic and polygenic. There are monogenic causes of cancer. They’re actually predispositions, not causes. Because if you have BRCA, for example, that’s not a guarantee that you have breast cancer, but it makes you, I think, four or five times more likely.
Plenty of existing companies, like 23andMe, already screen for BRCA variants.
23andMe does an array. They only look at, I think, 44 BRCA variants of the 70,000. If you only look at a few, then you can give people false certainty.
And they’re obviously not testing embryos.
Yeah, they just do people.
Whereas you sequence the entire genome of embryos—orders of magnitude more information, on both monogenic and polygenic conditions, than anything that’s ever been done before. Even your main competitor, Genomic Prediction, only does arrays of embryos, looking for specific things.
Yeah. Whole genome is a big deal and a massive upgrade. You can mitigate risks for thousands of diseases that previously you weren’t able to detect. It’s kind of like a vaccine for everything that we know, genetic-wise, at once.
And all off a very small amount of DNA.
About 5 picograms per cell in an embryo sample. That’s a really, really tiny amount. From both a chemistry perspective and a computational perspective, we had to invent new things to make it so that you can recover whole-genome data.
The absolute whole thing, all 3 billion bases or whatever?
99.6 percent coverage, on average.
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Walk me through your own decision to do this—to use Orchid’s technology on yourself.
I mean, I started the company because I wanted to test my own embryos.
Because of your mom, or because of who you are as a person?
Both. Reproduction is one of the most fundamental things in life. It’s like you die, taxes, and, you know, people have kids.
You always knew you wanted to have kids.
Oh, yeah. Yeah.
How old were you when you were like, “I should be able to sequence my embryos”?
I don’t think it was sequence my embryos specifically. I’ve always had an interest in genetics. I’ve always had an interest in fertility and reproductive tech.
Even as, like, a teenager?
I remember one of my applications for the Thiel Fellowship definitely had a version of Orchid on there.
That was, what, over a decade ago, and a lot of prospective parents still rely on the same genetic testing we used back then.
I would consider it negligent to use the old technology. Because you’re by definition missing hundreds of things that could have been detected. Parents who are not told that this new technology exists are being done a huge disservice and will probably be suing if their child ends up with a condition.
You think that’s a legitimate lawsuit?
Of course. If your doctor doesn’t tell you that there’s a way for you to screen for your child to not have a condition that would be either life-threatening or life-altering for them—I mean, it's already happened. [Parents have been suing physicians for failing to perform genetic tests since the late 1980s.]
How much does an Orchid screening cost?
It’s $2,500 per embryo.
And presumably you’d be screening several embryos. What about for families that can’t afford that?
We have a philanthropic program, so people can apply to that, and we’re excited to accept as many cases as we can.
Your clientele, at the moment, must tend toward well-off optimizers—people who really fuss about numbers.
I guess you’re right. I mean, I don’t know.
Do you ever worry about that? Giving people, like, more things to worry about?
No, no, no. I think it’s the opposite. For the vast majority of our patients, it reduces worry.
There must be exceptions.
There are some people who, I agree, are kind of anxious. And I just don’t think they should do any genetic testing.
Oh yeah?
I mean, everyone’s different. It’s just that I want to expand the menu of choice. You get to choose your partner. You get to choose when and if you have kids. This is, like, this is your kid. Why would you censor information about that?
But this still makes a lot of people extremely uncomfortable. There’s a fear, so often, around anything that touches reproduction. Are we, I don’t know, afraid of playing God or something?
Every other time we examine something, we develop—we develop insulin, right? We’re like, “That’s great!” It’s not like you’re playing God there. But you actually are, right? You’re creating something that didn’t exist before.
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But I have to believe there’s a difference between something like insulin and something like reproduction. I’m not terribly religious, but one just seems more—forgive the religious word—sacred than the other. Do you not see it that way?
No, I definitely see it as something sacred and beautiful and special and, like, magnificent. But that’s actually why I want to give more care to it.
And you’re saying the care that exists today isn’t sufficient.
Why is it that 90 percent of women, when they give birth, have vaginal tearing? Your genitals rip. Like, what the fuck? That’s not cool. That’s horrific. Some women still die. This process of giving birth is something that’s very critical for the human species, yet there isn’t the amount of energy and engineering effort put into it that I think it deserves and merits. And I think we’re starting to see that, right? With population decline?
See what? Women choosing not to have kids?
Women are like, well, no. We don’t want to do this anymore.
Does population decline worry you?
I mean, it’s super important. The population of all of the places we love is shrinking. In 50 years, 30 years, you’ll have half as many people in places that you love. Society will collapse. We have to solve it. It’s very critical.
Why?
We need humans! Humans are the ones who are innovating, making new things, making things better.
And you blame declining birth rates on the lack of attention to reproduction?
There’s a lot of different reasons why women are choosing to have fewer kids. But I think one piece of it is definitely the technology portion of, well, why don’t we make it way safer and way better and more confident for people going through pregnancy?
Why did you name your company Orchid?
It’s kind of like what you were saying—people are naturally afraid of any reproductive technology. So I was like, “Well, what’s something that I really like that I think represents this whole thing?” Flowers.
You were trying to make it sound less scary.
There was a spreadsheet. There were actually a lot of different other flowers.
Like what? Rose? Tulip?
I think we considered almost all the flower names. I don’t remember what the reasons for disqualification were. Maybe they were too hard to say, or—
Chrysanthemum!
Oh yeah, or too long. I do love orchids. I think they’re beautiful flowers.
I must now ask a question I’ve been dreading. I’m sorry in advance. Here goes. It’s the inevitable question about Theranos and Elizabeth Holmes.
No, this is the worst question. This is so mean.
Tell me why it’s so mean.
I find it sad. It’s a sad state of affairs where—my friends who aren’t even in health, they say they get it too. It’s like, any female CEO with any tech-adjacent thing is constantly being questioned—by the way, are you like this other fraud? Do you want to comment on this other random fraud that occurred that has absolutely nothing to do with you besides the person being the same gender as you?
If you’re trying to charitably understand where this question is coming from, how do you do that?
What would be the charitable interpretation—besides that our society is incredibly misogynistic and men’s frauds and failings are passed aside and when one female does it she stands for every other female CEO ever?
So there’s no charitable interpretation.
I don’t think there is. Society treats men as, like, default credible. For a woman, the default is skeptical.
This interview has been edited for length and clarity.
