Noor Siddiqui recently created 16 embryos through in-vitro fertilization (IVF). Neither she nor her husband have a fertility issue, but Siddiqui had always known that she’d want to conceive this way.

She grew up watching her mom lose her vision to a rare degenerative condition called retinitis pigmentosa, and wanted to do everything possible to give her own child the best chance at a healthy life. This included starting her own company and being the first customer of the product she needed to exist before having kids herself.

Incredibly, Siddiqui and her team have pulled off what society has been dreaming might be possible for half a century. Orchid, a reproductive technology company, is now offering the world’s first whole genome report for embryos.

Traditional embryo screening (preimplantation genetic testing, aka “PGT”) screens for extra or missing chromosomes. Orchid goes much further by reading the entire genome and looking for errors that could manifest as disease, much like spellchecking a book for mistakes. Orchid screens for genetic forms of neurodevelopmental disorders, pediatric and adult-onset cancers, and birth defects. It screens for 1200+ genetic variants that are known to cause disease, all simultaneously — a massive upgrade from embryo screening that would previously only scan for a single gene. The amount of DNA read by old screening is also under 1%, compared to Orchid’s 99% coverage. All the information is gathered from screening just five cells from the five-day-old, ~125-cell embryo: the same sample size used across all IVF centers for the past 10+ years.

But toying with reproduction isn’t child’s play. Siddiqui’s work has been met with criticism and backlash, like concern that her efforts will enable parents to control every aspect of their future children’s lives, starting with their health.

Still, Siddiqui presses on. “I honestly think it's unethical to stigmatize choosing screening. In every other aspect of your life, you're trying to reduce suffering,” she says, referring to how no one questions whether going to the hospital to get a cast for a broken leg is “playing God,” or tells a cancer patient not to get chemotherapy because it was “God’s plan” for them to die of cancer. She thinks it’s unacceptable to expect parents to simply be prepared to grieve the loss of a child who has succumbed to a genetic disorder — especially if this suffering could have been avoided with access to technology like Orchid.

Siddiqui’s devotion to what she’s building is apparent in her defense of Orchid’s ethics, but it’s even more apparent in her vision for the future: a world where all babies will be born using the Orchid method and, by extension, IVF. The way she sees it, Orchid is the first step towards building a healthier future — but its success in doing so will rely on a whole new way of procreating.

Siddiqui hasn’t had any of her embryos implanted yet. She’s still waiting to decide when it's the right time. But she’s always known that she wanted to have kids. Given her mom’s condition, she knew she would take a different approach to making this dream come true.

“You and I won the genetic lottery,” she tells me. “We get to see, and we did nothing to deserve that. And then for my mom, her independence and all of her plans just got ripped out from underneath her because of something totally random. I just really felt it was profoundly unfair.”

At 17, Siddiqui was awarded a Thiel Fellowship, a two-year, $100K grant from PayPal founder and early Facebook investor Peter Thiel to skip the traditional college track and invest in building something of her own. After the fellowship, Siddiqui enrolled at Stanford where she earned both bachelor's and master’s degrees in computer science, worked as an AI researcher, and taught a course on “Frontiers in Reproductive Technology.”

“I worked in a bunch of AI labs on applications of deep learning, and I was surprised to see how much genomic data actually existed. Fifteen years ago, when my mom was getting diagnosed, these data sets were tiny,” she recalls. “It was cool to see genetics become a computational science. And it was cool to be able to meet with experts, both on the embryology side and the clinical side, to get more context on what exactly happens during IVF.”

Shortly after graduation, Siddiqui got engaged and thought carefully about what she wanted most for her future children. It all kept coming back to health. She knew it was unfair that people like her mother sometimes get dealt bad genetic luck — through no fault of their own. What if we could make our own luck, and decrease the odds of disease? Equipped with entrepreneurial experience and a new education, Siddiqui set out to build a new way of maximizing her chances of having a healthy baby.

As it currently stands, Orchid is available at over 70 IVF clinics across the United States. The company is also backed by well-known investors like Elad Gil (cofounder of Color Genomics), Brian Armstrong (CEO of Coinbase), Vitalik Buterin (creator of Ethereum), Mario Schlosser (founder of Oscar Health), and Kevin and Julia Hartz (cofounders of Eventbrite). The latter two were also among some of Orchid’s first customers.

But the first baby born with help from Orchid was only born late last year. The baby’s mother was 38 when she got married, and her husband had several genetic conditions in his family, so the couple felt that using Orchid was a no-brainer.

“I just think reproductive choices are constantly stigmatized and shoved down women's throats, and it should be the opposite,” Siddiqui says. “It should be, ‘Hey, here are all the options. You can make an educated choice about whether you want to have kids or not, whether you want to have them at home or at the hospital, whether you want an epidural or you don't, whether you want to get information about your embryos, whether you want to do IVF, etc.’ All the options should be discussed honestly, at the earliest possible stage.”

In Siddiqui’s opinion, the options that Orchid introduces for would-be parents aren’t anything more than a natural next step for the future of reproduction. Just like women have the option to give birth in hospitals to reduce maternal and fetal mortality risks, why shouldn’t they have the option to screen their embryos and ensure the health of their baby?

Siddiqui’s mission is for Orchid to not only become the default way people have kids, but for Orchid to make the whole process — from IVF to screening to birth — more affordable, convenient, and intuitive.

Orchid’s current price is $2.5K per embryo, plus the cost of IVF, which can be upwards of $20K per cycle. Siddiqui says it is still a ”drop in the bucket” compared to the cost of gene therapy for treating conditions Orchid could have screened for. Gene therapy for her mom’s condition, for instance, costs upwards of $800K per eye. That treatment also doesn’t prevent blindness — it just prevents vision loss from progressing. To make matters worse, most genetic disorders don’t even have corresponding gene therapies because of how difficult they are to develop and how small the markets can be for them.

“10% of Americans — 30 million people — have rare diseases. They're individually rare, but if you add them up, you get 30 million,” Siddiqui explains. She stresses that Orchid is not only much cheaper than gene therapy but also has a much larger market. It can screen for hundreds of disorders and genetic health risks at once. She’s confident that if everyone uses Orchid, millions of future lives could be improved.

Though her hope is that insurance companies and governments will eventually cover IVF and the cost of embryo screening, she’s pleased that people want the service even at its current price. “IVF is a place where people vote with their feet,” she says. “We owe our success to the fact that our customers choose an IVF clinic based on whether or not Orchid is available.”

Orchid’s challenges lie more in scaling operations than in attracting customers or employees. It’s such a high-stakes sector that the quality bar for everything has to be incredibly high. Siddiqui has instilled this mentality in her team, encouraging them to overperform on many benchmark quality metrics above and beyond what is standard in the industry. It’s challenging to scale when optimizing so aggressively for quality. But the payoff for these efforts, she says, is overwhelmingly rewarding.

“Every customer is coming to us to have a baby and it’s impossible to not be excited about that. You’re working with individuals on the most special moments of their lives — to maximize the chance it’s a happy moment.”

Of course, Siddiqui’s work is a reflection of her own values. As far as she’s concerned, the more healthy people on the planet, the better. She’s aware that fertility rates have been dropping around the world and that degrowth movements are growing in popularity due to concerns over climate change. But Siddiqui doesn’t think advocating against reproduction is the answer. If environmentally-conscious people have kids, she says, their values “will propagate into the future, versus if they don't, then those values will die.”

She’s also prepared to defend against accusations that embryo screening promotes discriminatory eugenics. She says it’s the exact opposite of what was seen in 20th-century America, where eugenicists would forcefully sterilize those they felt were “genetically inferior” and prevent them from having the ability to have kids. Instead, IVF allows parents, whether they are struggling with infertility or a genetic disease, the ability to have children with more confidence and assurance. It gives parents more power, control, and information, to make the decision that is right for their family, rather than the government dictating who can and cannot reproduce.

But what about other types of discrimination? One might argue that bipolar disorder, for example, is something many of the world’s best artists share, like Sylvia Plath or Vincent van Gogh. Perhaps the disorder predisposes people to be more artistically inclined. After all, it’s frequently theorized that neurodiversity evolved, at least in part, to our collective benefit.

Siddiqui argues that upfront information can help parents better prepare for children even in the case where those children carry genetic risks — but it doesn’t stipulate what a customer does with it. A couple can decide which risks they are and aren’t comfortable taking on, and feel empowered while making, ostensibly, the most important decision of their life: choosing to have a child. Orchid also gives prospective parents the chance to "recruit the maximum resources of their communities" even prior to getting pregnant so that children who are susceptible to certain disorders can have the best treatment and support possible in the future.

In the face of all ethical criticism, Siddiqui stays firmly resolute. Because, to her, it’s work that is ultimately in service of choice, not necessity.

“I think that this whole process of life-giving should be celebrated and should be put on a pedestal. This is one of the most amazing things anyone ever does, and women should be respected and given the maximum amount of information and choice to navigate it for what's best for their families.”