The woman will decide which babies are born

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It’s often called “genetic enhancement.” Whenever I bring up Orchid in polite company, people squirm.
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.
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.
It’s made me savor and appreciate a lot of those moments more, and be a little bit more present.
It’s a sad state of affairs where—my friends who aren’t even in health, they say they get it too.


Praise be to God for the babies! Or, without God, a fertility startup named Orchid. It presents a dream choice to aspiring parents: have an orchid baby or a normal baby. A typical infant may develop cancer in adulthood. or have a profound intellectual handicap from birth. alternatively become blind. or get fat. A typical infant might not even survive to give birth. Adopting her method, according to 29-year-old Noor Siddiqui, significantly reduces the risk of any of those things happening to an Orchid baby. It is frequently referred to as “genetic enhancement.”. “.

People flinch whenever I bring up Orchid in a polite setting. “I feel uneasy,” they utter. “Not in my opinion. So strange. Nazis and a related word that begins with “eu” and ends with “genics” are unavoidably brought up. Orchid would rather that I not say that. When I spoke with one new mother in particular, she was extremely, extremely disturbed. A few minutes later, she tried to shift the conversation by telling the room that she had just given her 6-month-old his first peanut and would be giving him his first shrimp in three months because that’s what the science says she has to do to keep him from getting allergies.

Which is, of course, Siddiqui’s whole pitch: to shield future generations from suffering based on scientific findings. That explains why Siddiqui founded a medical startup when she was a teenage Thiel Fellow and why she founded Orchid at the age of 25. That’s also the reason she wanted to be among the first customers of the company when its gene-enhancing product became available.

Siddiqui and her spouse are highly fertile, but embryos are necessary for the success of this type of intervention. Siddiqui therefore underwent IVF at Stanford in 2022, came up with 16 candidates, and sent representative slivers to Orchid’s lab in North Carolina. Preimplantation testing usually only looks for concerning anomalies, after which a physician chooses the most attractive candidate. No, that is not this. This is the first-ever image of each unborn child’s genetic destiny, and Siddiqui tells me it “has been on society’s mind—sci-fi’s mind—for a generation.”. Currently, Orchid determines each embryo’s probability of developing any of the more than 1,200 illnesses and ailments for which we currently have genetic information ranging from extremely precise to, well, hazy and extrapolative. Who knows what calculations it will make later?

With 16 workers and $12 million in funding, Orchid is still in its early stages of development. However, they currently have thousands of clients and are present in 40 IVF clinics nationwide. This reportedly involves a number of well-known tech personalities. Siddiqui laughs when I ask her to reveal their identities, but she is more than willing to provide me with the information about her own embryos. On a perfect day, she does this in front of a coffee shop in the Mission neighborhood of San Francisco, which is close to her home. When she opens the report on her laptop, it has an elegant layout with a variety of graphs and figures, some highlighted in black (strong odds against schizophrenia), others in red (not so good for breast cancer). We would only discuss the percentages, percentiles, and “penetrances” if Stanford-trained computer scientist Siddiqui had his way. However, I keep trying to dissuade her from the statistics and what the science—as she puts it—says. Since that isn’t the entire narrative. Because this is also a science fiction story, as she acknowledged in her own words.

Jason Kehe: Before we talk about your embryos, I recently found out that you have a new podcast where you discuss a ton of sci-fi and futuristic topics in addition to Orchid. Must I give it a listen?

Noor Siddiqui: Well, most certainly. It has had some incredible guests. I adore the writer Tim Urban, do you know who he is? He has fundamentally altered the way I think about time. You have seen his Life Calendar materials, correct?

Hast I?

Essentially, he merely illustrates how, by the time you turn 18, you will have spent 90% of your life with your parents—and how, indeed, the moments we share with one another are far more valuable and nonrenewable. It’s helped me to be a little bit more present and to cherish and appreciate many of those moments more.

It makes me think of Orchid’s beginnings, where your mother is involved. For a hereditary reason—.

The medical condition known as retinitis pigmentosa, huh.

True enough, she lost her vision.

Although she isn’t completely blind, she has been declared legally blind for some time.

which, yes, was one of the motivations behind your founding Orchid. But whenever I think about this story, I imagine that you—the future daughter of the rejected embryo—would not exist if Orchid technology had been around back then, if the batch of embryos containing your future mother had been screened, and if her parents—your grandparents—had chosen a different embryo and had a different child because they did not want their child to grow up with retinitis pigmentosa. Correct? Do you consider that? Is that a reasonable point of view?

It makes some sense to me, but it doesn’t really.

Well, this has probably been brought up by others.

Indeed, they have. I’m not going to erase my mother, that’s all.

However, there is a world in which you would have, in a sense, erased her.

Though, in my opinion, if I had a mother, she would not have endured the same level of suffering as she did. Mom would not have needed to lose her sight. That way, I wouldn’t have had to witness her suffering.

Not to sound like a broken record, but you wouldn’t have existed, so you wouldn’t have had to witness her suffering.

That version of me would be different.

I don’t know anything about your mother, but I imagine she’s a fantastic person.

She’s not, though. She is truly remarkable. Sure. Furthermore, she prefers to be able to see.

Perhaps there wouldn’t be adult-onset blindness in the world after all. or without children suffering from cancer in their youth or birth defects. Sure. However, these individuals frequently carry on with their lives, leading lives that are both meaningful and transformative.

True enough. Of course.

Who’s to say, then, that by getting rid of these circumstances, we aren’t also getting rid of the kind of person who would then, say, want to improve the world?

Throughout human history, efforts have been made to alleviate suffering and increase the number of individuals who can fully engage in society. Indeed, and in addition, there is this group of extremely susceptible individuals with hereditary diseases. All they are told to do is to take a chance and hope for the best. For example, heart attacks and diabetes are very common among South Asians. Like, that is really bad. That seems incredibly unfair to me.

However, you believe that to be unjust due to the nature of your mother. since she experiences pain. You felt moved to put an end to other people’s suffering because of something that she went through. Is that a coherent statement?

No, that is not logical. Regretfully, not every illness is inherited. Sickness and pain will persist. We don’t really embody an idealistic dream. We’re removing the possibility of danger. For instance, between 10 and 15 percent of cancer cases overall have a genetic component. Hence, cancer will still affect 90% of people. Likewise with birth defects and neurodevelopmental disorders. Just more parents will be able to make the most significant decision of their lives—deciding whether or not to have children—with greater assurance and knowledge thanks to it.

Which diseases seem to be the most concerning to prospective parents?

cancers with both pediatric and adult onset, congenital abnormalities, and neurodevelopmental disorders.

Would you call these “polygenic,” meaning that their regulation is influenced by the interactions of several genes?

Every one of these is monogenic.

Only one gene is linked to cancer?

That’s a really good point, all right. Considering that cancer can have multiple causes. A number of factors can be monogenic. Actually, they’re not causes but rather predispositions. Because, for example, having BRCA increases your risk of breast cancer by, I believe, four or five times. However, having BRCA does not guarantee breast cancer.

Numerous established businesses, such as 23andMe, currently perform BRCA variant screening.

23andMe performs an array. Out of the 70,000 BRCA variants, I believe they only examine 44. People may be misled into believing something if you just consider a small number.

Furthermore, it’s clear that they are not testing embryos.

Indeed, they simply do people.

On the other hand, sequencing an embryo’s whole genome yields orders of magnitude more information than any previous research has ever done on monogenic and polygenic conditions. Even Genomic Prediction, your chief rival, exclusively examines arrays of embryos in search of particular genes.

True enough. The whole genome represents a significant advancement. For thousands of diseases that you were previously unable to identify, you can reduce your risk. All of our knowledge about genetics is essentially covered by one vaccine.

And to top it all off, very little DNA.

About 5 picograms per cell in an embryo sample. That is an extremely small sum. To recover whole-genome data, we had to develop new methods from the perspectives of chemistry and computation.

the entirety of it, all three billion bases, or something else entirely?

A 99.6% coverage rate is average.

Explain to me why you chose to use Orchid’s technology for personal use.

Really, the reason I founded the business was to test my own embryos.

Due to your mother, or due to your personal qualities?

both. One of the most basic aspects of life is reproduction. It’s as if taxes are due, people die, and so on.

You’ve always known that you want children.

Yes, that’s correct. True enough.

When you felt that “I should be able to sequence my embryos,” what was your age?

It wasn’t, in my opinion, a specific sequencing of my embryos. My interest in genetics has always been strong. Reproductive technology and fertility have always piqued my interest.

even when you were a teenager?

There was undoubtedly an Orchid version on one of my Thiel Fellowship applications, as I recall.

Many would-be parents still depend on the same genetic testing that was done more than ten years ago.

To me, using outdated technology is irresponsible. Due to the fact that you are inherently overlooking hundreds of potential detections. If their child develops a condition, parents who are unaware of the existence of this new technology will likely file a lawsuit.

Do you believe the lawsuit has merit?

Obviously. It’s already happened that if your doctor doesn’t inform you that there is a method for you to screen to make sure your child doesn’t have a condition that could either be life-threatening or drastically alter their quality of life. From the late 1980s, doctors have been sued by parents who claim that they neglected to order genetic testing. ].

What is the price of an orchid screening?

Every embryo costs $2,500.

Additionally, you would probably be screening multiple embryos. What about those families who don’t have that kind of money?

People can apply to our philanthropic program, and we’re eager to take on as many cases as we can.

Now, the people who should be your target market are wealthy optimizers—individuals who are extremely meticulous about their data.

You must be correct, I suppose. To be honest, I’m not sure.

Giving people more things to worry about—do you ever worry about that?

No, no, no. I believe that to be false. It lessens anxiety for the great majority of our patients.

There needs to be some exclusions.

I agree that some people experience some degree of anxiety. Furthermore, in my opinion, there should be no genetic testing done.

Yes, that’s right.

Everyone is unique, after all. All I want to do is increase the selection of options. It’s up to you to select your partner. You are free to decide if and when to have children. This seems to be your child, somehow. Why would you censor such information?

Still, a lot of people find this to be really unsettling. Anything that has to do with reproduction is so frequently fraught with fear. Is it that we’re afraid to act like gods or something?

It’s not like you’re playing God there; every other time we examine something, we develop—we develop insulin, right? We go, “That’s great!”. You are, after all, creating something that didn’t previously exist, isn’t that right?

However, I have to think that there are differences between things like reproduction and things like insulin. I’m not very religious, but there seems to be a greater sense of sacredness to one than to the other. Don’t you think that?

No, I truly believe that it is a sacred, lovely, unique, and truly magnificent object. I actually want to give it more attention because of that.

Furthermore, you claim that the current state of care is insufficient.

Your genitalia tear, which is why ninety percent of women experience vaginal tearing after giving birth. Like, what the fuck? That’s not cool. That is horrifying. There are still some deaths of women. The process of giving birth is vital to the survival of the human species, but it doesn’t receive the attention and technological advancement that I believe it merits. I believe that we are beginning to witness that, given the decline in population.

What? Women are choosing not to have children?

Women say, “Well, no.”. This is something we no longer wish to do.

Are you concerned about population decline?

It’s really, really important. Every place we adore has fewer people living there. The number of people in the places you love will be halved in 50 or 30 years. There will be a collapse in society. It must be resolved. It is extremely important.

And why?

Because they are the ones who are creating new things, innovating, and improving things, humans are what we need most.

And you attribute the decline in birth rates to a disregard for reproduction?

Women are opting to have fewer children for a variety of reasons. Nonetheless, I believe that technology plays a significant role. Why don’t we improve, make it safer, and give expectant mothers more confidence?

How come you called your business Orchid?

It’s similar to what you mentioned in that human beings are inherently terrified of any form of reproductive technology. I thought, “Well, what really appeals to me that I think captures this whole thing?” and immediately thought of flowers.

You made an effort to tone it down.

It was a spreadsheet. In actuality, there were numerous other varieties of flowers.

Like a rose or tulip?

We probably thought of nearly every name for a flower. I can’t recall the grounds for disqualification. Or perhaps they were too difficult to say.

A Chrysanthemum!

Yes, or it was overly drawn out. I really do adore orchids. These are lovely flowers, in my opinion.

Now, I have to ask something that has been on my mind a lot. Thank you ahead of time. Now let’s get started. The question regarding Elizabeth Holmes and Theranos is unavoidable.

No, this is not the most inappropriate question. That is really cruel.

Tell me why it is so cruel.

It saddens me. It is a disheartening situation in which even my non-ill friends claim to understand it. It seems like every female CEO in any tech-related field is asking the same questions over and over again: Are you like this other fraud, and do you want to comment on this other random fraud that happened that has nothing to do with you other than the fact that the perpetrator is your gender?

How can one empathetically try to understand the origin of this question?

What is the charitable interpretation, other than the fact that men’s deceptions and shortcomings are overlooked in our highly misogynistic society and that a single female CEO represents all future female CEOs?

So, a charitable interpretation is not possible.

No, in my opinion. Men are considered credible by society by default. A woman’s default attitude is skepticism.

The length and clarity of this interview have been adjusted.

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