Orchid’s Noor Siddiqui: Rigging The Genetic Lottery To Create Healthier ‘Superbabies’

0:00Having a baby is like starting a company. Things can go wrong, often in unexpected ways. But what if things went right? What if you could guarantee that your child would win the genetic lottery? ORCID is building technology that screens embryos during IVF for hundreds of conditions, from pediatric cancers to chronic illnesses. Our guest today is ORCID's CEO, Noor Siddiqui, who calls the result super babies.

0:24Noor Siddiqui:We had to spend years actually inventing a new technology to be able to read the entire genome of an embryo, right? So we're the first company in the world to be able to read the entire genome of an embryo, which is 100 times what was available previously. Your team is at capacity and you need to fill roles fast. Don't panic. You have Rippling AI. Built on your live workforce data, Rippling AI can tell you what it would cost to add two more engineers this quarter, then draft the job recs and kick off the hiring workflow. All you have to do is ask, review, and approve. Don't settle for AI that's all talk.

0:57Head to rippling.ai slash upstarts. That's R-I-P-P-L-I-N-G dot A-I slash upstarts to sign up for exclusive access today. Today on the podcast, we're going to talk about how Orchid actually works, the stigma around reproductive technology, and how Noor deals with her skeptics, critics, and haters. She's also going to try to convince me that the West Coast is the best coast. I'm Alex Conrad, founder and editor of Upstarts Media. And this is the Upstarts Podcast, our weekly show about startup founders who punch above their weight and take on the status quo. Noor, welcome to the show.

1:35Noor Siddiqui:Thank you so much for having me. This is amazing. So we're here in San Francisco where you're based and you've been working on Orchid for a few years now. Can you tell everyone what is the mission of Orchid Health? Yeah. So at Orchid, we want to help everyone have a super baby. If you have a baby the old-fashioned way, you're basically rolling the dice and you get an average outcome. And if you come to us, you can stack the odds in your child's favor and have a super baby. And so when people are thinking about a super baby, should they be thinking about the types of conditions or traits that we wouldn't want that would make us concerned in having a baby?

2:11Or is it more about having a baby with better traits and sort of that superhero vibe that I think super baby implies, at least for me?

2:20Noor Siddiqui:Well, yeah, I think it's just something that, yeah, the media has kind of taken on. It's kind of taken a life of its own. So we've sort of more embraced it. But what it means concretely is that, unfortunately, when a embryo is created, when a human life is created, there's a lot of risk. Right. There's this idea of a genetic lottery that happens. Right. And actually, if you think about it, it's sort of like the most unfair thing that ever happens to people, right? Based on this genetic lottery, it's literally the difference between are you going to live a healthy life into your 90s or to 100, or are you going to not make it to your first birthday?

2:55Noor Siddiqui:That's literally determined by a bunch of genetic coin tosses that neither parent has any control over. I just thought that was insanely unfair. And yeah, I think that the most obvious thing, at least for me as a future parent, that I want to be able to give my child is to have their genes not work against them and hijack their entire life. Right. So I grew up watching my mom go blind. Just the process of her getting a diagnosis took close to a decade. It was like these constant specialist visits and different experts trying to find out what was wrong. And at the end of it all, it was basically, hey, there's nothing we can do.

3:35Noor Siddiqui:There's no way to reverse the vision loss. You're definitely going to go blind. You start by losing your night vision. Then she lost her peripheral vision. And then she lost her central vision as well. and like she didn't start smoking. It's not like she did something to cause that, right? It's just that there was this genetic program running silently inside of her that just took something, you know, that I think, you know, a lot of us really value away from her, right? Like a single base pair can be the difference between, you know, being able to see your grandkids' faces or not, right? If you think about my mom's story, it's actually comparatively incredibly mild to what hundreds of millions of people face, right?

4:15Noor Siddiqui:So 400 million people actually like globally have genetic diseases and, you know, 95 % of them don't even have an FDA-approved treatment, much less a cure, right? So, you know, when people are going out to do the most important thing they're ever going to do, right? The most consequential decision ever is like to have a child. I think it's actually insane that the default is that we go into that completely blind with no information, right? Like we spend more time and more energy researching, you know, where we're going to go to lunch or what stroller we get for our child. And those are extremely, you know, inconsequential, right?

4:53Noor Siddiqui:It doesn't matter at all what stroller you get or where you go to lunch, but your child's genome is fixed for life. And the consequences are literally the difference between, you know, a life with pediatric cancer or a blissfully unaware life where you're having to go to the doctor for chronic illnesses that a lot of people are facing. Sounds like your mother's experience was a powerful inspiration for you. How old were you when her condition changed? Or was this a formative experience for you at the time or something that you saw later and said, okay, this is something that is affecting me? Yeah, it actually really didn't affect me in childhood, right?

5:32Because it was actually very gradual, right?

5:35Noor Siddiqui:Like the vision loss is quite gradual. I really don't think it actually affected me until much later, right? It was really much more when I was closer to getting engaged and thinking much more concretely about a baby, not in the abstract as, oh, one day I'll have a baby, but more concretely with this specific person. And then reflecting back on the experience. Part of why I ask is because I'm curious if you already were pretty set on the path of being an entrepreneur when this started to be something that you were thinking about deeply. and it then sort of redirected or shaped which path as an entrepreneur you went on?

6:11Or if in the back of your mind, this was always a problem that maybe you would have wanted to try to solve someday?

6:18Noor Siddiqui:For me, it was really just like, this is the thing that I care about the most and that I really want to exist and that I was really disturbed is how the world worked, right? I don't know how else to describe it, but I just thought it was like, it's insanely unfair that this happened to my mom. And it's just insanely unfair that we just generally accept this idea that we're going to randomly get horrible diseases that we can't cure and we can't even really treat well. And we're just going to accept that that's what happens. And I think that when it became more concrete to me, like, hey, I'm going to be having a baby with a specific person.

6:52Noor Siddiqui:What do I think actually matters as a parent? Like, what do I actually want to do? For me, it was like the most obvious thing was I want to be able to, you know, scan my embryo for thousands of different diseases and maximize the chance that they're going to have a healthy life. Because to me, that's actually the most important parenting decision I'm ever going to make. Right. It's basically two really important parenting decisions. It's like, who's your other half? That determines that's going to shape them. And then is their life going to be hijacked by something horrible like what happened to my mom or something that, you know, you know is in your family.

7:24Noor Siddiqui:I guess it's quite selfish, but that's really what it was. It was sort of like, why is no one working on what I thought was the most important problem? And, well, if they're not going to work on it, then I have my own timelines for when I want to have kids. So I better get started. So why was no one working on the problem? Obviously, IVF has been around for a while. It's not how most of us are on the planet right now. But I guess a growing number of people are turning to IVF. Was this just not a big enough market or the technology wasn't there yet? Why was there an opportunity for ORCID to step in and advance the capabilities and possibilities here?

8:04Noor Siddiqui:Yeah. Honestly, I think it's all of the above, right? There's a massive amount of stigma around reproductive technology. Like, there's a huge cultural baggage. Like, I don't think most people realize that condoms were illegal 50 years ago, right? There's two Supreme Court cases fought over condoms, right? the first one was fought over giving married women access with the permission of their husbands and then the second was fought over giving unmarried women access right so something like extremely routine right the idea that contraceptives should exist and that people you know women should be able to choose when they get pregnant which is yeah i think a pretty broadly accepted idea today was literally illegal like not even you know in a lot of people's lifetimes, right?

8:49Noor Siddiqui:IVF was also met with intense skepticism, right? A lot of things that we take for granted, right? Like epidural, for example, right? Epidural was originally considered women were supposed to be experienced pain in childbirth, right? So there's a lot of cultural baggage around, okay, this is the way that birth should be done. And I think that that idea has seeped into genetics too, right? This idea that, oh, it should be random, like random is somehow better, right? We don't accept that in any other part of our life. Like, no other place are we like, oh, we should, you don't accept a random partner, you don't accept a random job, you don't accept, like, a random place to live.

9:25Noor Siddiqui:Like, these are all deeply considered decisions. But for some reason, the most consequential decision, right, which is, like, which child you're going to have was somehow supposed to be, is considered sacred to, like, leave it to chance. And I think that if you're on the other side of it, like, when chance goes wrong, right, and you see a child die, if you see a parent degrade beyond the point where they're kind of unrecognizable, you sort of realize that, hey, this genetic lottery really isn't so great a lot of the time, right? I think that's kind of like the taboo piece of it. And then, yeah, I think the other two are also there, right?

10:01Noor Siddiqui:So from the technology side, we had to spend years actually inventing a new technology to be able to read the entire genome of an embryo, right? So we're the first company in the world to be able to read the entire genome of an embryo, which is 100 times what was available previously, right? So we had to actually invent a new what's called amplification technology. Because when you have an embryo, you only have about 30 picograms of DNA. A picogram is a trillionth of a gram. So it's a really, really tiny quantity of DNA. So if you think about blood or saliva, you don't need amplification, right?

10:34Noor Siddiqui:You can just throw it on any type of sequencer and you can get your whole genome sequenced. But with an embryo, because you have this really tiny quantity of DNA, we actually had to invent a new method to be able to actually get that full readout on, you know, a day five old embryo. So pause right there. For people who maybe haven't gone through the IVF process, they think they know what it is, but maybe they aren't fully up to date. Yeah, yeah. What was the limiting factor? Why was the IVF process before ORCID just scratching the surface here and not going through these checks? It sounds like there was a fundamental technological problem.

11:08But was this something that people were like, you know, it would be great if we could scan for all these things, but it's not possible. And you had to rethink what was possible there or what? It was both. It was base.

11:18Noor Siddiqui:Basically, there was a unwillingness to look and there was a technological problem of how would we actually look. Just kind of backing up the way that IVF works is, you know, in your ovaries, you have a bunch of eggs. usually you ovulate one egg a month, but in every month a bunch of eggs actually die. So you actually anywhere from dozens to hundreds of eggs die every month. And what the IVF or egg freezing process does is it actually preserves those eggs. So you basically hyperstimulate your ovaries, meaning you get, just like you have follicles for hair on your head, you have follicles for eggs in your ovaries.

11:51Noor Siddiqui:So what the medication does is it synchronizes a bunch of eggs and you kind of retrieve or kind to capture a basket of eggs during a cycle, meaning one specific month. And then you can either freeze those eggs, that's egg freezing, or you can fertilize it with your partner's sperm, and then you make embryos. Those embryos grow for five days. And then on day five and six, an embryologist takes a laser. It's called a biopsy, but it's kind of like a haircut of the outer cells of the embryo. So about five cells get sent to Orchid's lab for analysis. And then the parents and their clinical team get reports.

12:27Noor Siddiqui:So they get a report on each embryo about thousands of different genetic factors, and then they get to make a decision about which embryo to transfer. And the reason that's a massive upgrade over what previously existed is you can think of the genome as like you have 3 billion letters, right? And these 3 billion letters are organized into 23 chapters, right? 23 chromosomes, you know, 23 and me. And really, because of this limitation of the analysis of that really tiny amount of DNA, you could only look at the chapter level. So what that means is like, imagine you had a proofreader for a book, and the only question they could answer for you is, does this book, you know, have 23 chapters or not?

13:08Noor Siddiqui:It couldn't actually read any of the words, can't actually do any spell check. That's kind of where the technology was stuck. And then we would just say that's feasibly the best we can do. And I guess, was that also considered acceptable because that is kind of on par with the level of info we have from a traditional reproductive process where you're sort of looking at, you know, the first sonogram and saying, or doing the first test and being like, we think your baby is going to be okay? Yeah, it's kind of similar, right? So basically in both settings, you know, chromosome analysis of embryos and what's called NIPT, so at 10 weeks of pregnancy, you can get a blood test.

13:47Noor Siddiqui:And it also can give you some genetic information about the fetus. But in both of those contexts, you're getting a really, really limited picture of the genetics of either the embryo or the baby. So you're only able to scan for a tiny number of diseases because, again, you're only looking at 1 % or less of the DNA. So really, the thing that was really important to me is I want the maximum amount of information. I don't want just the chapter level. I want to read every single letter because diseases are hiding in every single letter. Like if you think about what is a genetic disease practically, it's literally just a typo in those 3 billion letters.

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15:07Noor Siddiqui:that's r-i-p-p-l-i-n-g dot a-i slash upstarts sign up for exclusive access today are you that kind of person who wants the maximum amount of information in everything or was this something that was triggered partly because of your mom or sort of you got fired up where this specifically was the place where you're like we should always have more info yeah it's actually really funny i'm actually not um i would say information seeking in every context i think i'm more just like a, I don't know, whatever the opposite is of like Pennywise, you know, Pound Foolish, right? I just, I like to just do like the minimum to get like the maximum benefit, right?

15:42Noor Siddiqui:So I think that for whatever reason, like when it comes to like reproduction or babies, it's the opposite. Like everyone is obsessing and telling people to obsess over the wrong things, right? And to me, this is like the thing that's going to actually make the biggest difference in my child's life. So that's why I was like obsessed over it because it's sort of like whether or not I get organic food or not, it's not going to make as big of a difference as, you know, whether my child goes blind or, like, gets dementia. Like, those are going to matter a lot more. So it almost seems like this is actually, like, a massive payoff that I can get for comparatively little effort.

16:17Noor Siddiqui:But yeah, I'm not information-seeking in all contexts, actually. But you were a precocious teenager. You were a Teal Fellow, which means you agreed to to forego college and take grant funding to do a startup. But I don't believe it was this startup. It was a kind of different idea. But entrepreneurship was something that was interesting to you even back then? It's actually funny. I actually don't think it was entrepreneurship. I actually just thought school was really dumb. I barely went to high school. And I just thought it was a huge waste of time. And I was like, okay, great. This is a way to get out of college.

16:50Noor Siddiqui:But no, I don't think it was really about like, oh, I want to start a company. I think it was more just like clearly that group of people i think school i thought was really lame i was just like there's like nothing like this is extremely pointless information to like ingest and regurgitate i just hated it versus the people in the teal fellowship like i respected all of them right like they built things that i used right i was like that's cool like i like the idea of like learning from people who have made stuff that i actually use and interact with um and it has like made a dent in the universe.

17:21Was there someone who was a mentor who you particularly kind of admired as sort of a successful founder in the program?

17:28Noor Siddiqui:I actually don't even think it's about like success. I think it's the thing that really more broke my brain was the idea of like taking yourself seriously. I know that sounds really strange, but like, I think that high school, the whole enterprise is like not taking yourself seriously. It's like, okay, prepare for like in middle school, it's like prepare for high school, high school, it's like prepare for college. And it's like okay it's like this circular thing where it's like you're not you're constantly being told you're not ready and you need to like do all this stuff to be ready and i just feel like kids and students are like constantly diminished and um the west coast nantil fellowship was the total opposite it was like okay cool yeah like you should do that like it was always just like you have license to do the thing like it was that was just like insanely like mind-blowing to me right because i think the east coast not to shit on the east coast but i hate the east coast um you're You're speaking to a New Yorker who's just visiting San Francisco today.

18:18So thank you for that. Yeah.

18:19Noor Siddiqui:But yeah, I think the East Coast is like really old school. Like I feel like at least when I grew up in D.C., it was very much like, OK, so you should like study for a decade to become a lawyer or study for like a decade to become a doctor and like climb the ladder in Congress. right it was always like these like very tracked paths and then you're you don't have you're not given the voice to actually do something until like 20 years when you're like too tired to want to do anything different anyways do you know what i mean versus i think the the um ethos on the west coast is like the total opposite it's like do the thing like just do the thing and see if it fails or not and there's basically not as much yeah there's basically the tolerance for failure is just so much higher like i just met so many people who just like burned through tens of millions of dollars on what seemed like a trash idea and it was a trash idea and then it was like okay great well now i'm gonna do the other thing and then the next thing is also a trash idea great they get to put 100 million to that other trash thing and the third thing is like amazing and then that's like a you know multi-billion dollar company it's actually really funny i actually applied to the teal fellowship with this idea but i was still too um what's the word i don't know insecure scared or something to like really work on it because i was like who's gonna let a 17 year old handle their embryos and their precious cells and help them have babies.

19:37Noor Siddiqui:So yeah, I guess I waited until I was like 25 or so to start the company. And that was part of why I guess I went to Stanford was because I, you know, wanted to spend time like really deep, you know, in the research world and to really, you know, learn about all the nitty gritty details of like, what makes an IVF lab run? Like, you know, how do you actually build these models that stratify disease risk and things like that? But yeah, I think that like the real value of the experience wasn't like the mechanical things I learned, but it was more just, I don't know, like the license, basically the license to actually do the thing and to have seen it go sideways for people and be successful for people.

20:18You talk about how you could do anything you want. You go to the West Coast. Like it's maybe more iconoclastic thinking. You do go to Stanford, which is not necessarily the most rebellious, hard rock thing one could do.

20:30Noor Siddiqui:It was at the time. Basically, it was like going not going to college was like, oh, you're a rebel. And then going from the Teal Fellowship to college was like, oh, why would you do that? OK, so people are just in the order that annoyed as many people as possible. I like that. And so you got the you got the expertise basically that was going to arm you to launch Orchid. So was it in the back of your mind that this was the company you were going to do? Yeah, I've been thinking of it since I was like 16. So I've definitely been like obsessed. It's so weird. Like, I think at 16, it was much more immature.