Noor Siddiqui is the founder and CEO of Orchid, a company that offers whole genome screening for embryos created through IVF, giving parents unprecedented genetic information about their future children before pregnancy even begins. Currently, IVF clinics choose which embryo to transfer based on a visual “beauty contest” — looking at morphology under a microscope — which captures only about 1% of the genome. Orchid upgrades that to 99% of the genome, giving parents 100 times more data and the ability to screen for thousands of conditions including pediatric cancers, birth defects, neurodevelopmental disorders, genetic forms of autism, and complex polygenic diseases like celiac disease, heart disease, schizophrenia, and bipolar disorder. Parents can compare embryos using genetic risk scores — for example, seeing that one embryo is in the 99th percentile of risk for heart disease while another is in the 50th — and select the one with the lowest genetic risk. This is the first time in human history that parents can meaningfully shift their child’s genetic risk profile, something previously fixed at conception by chance.
The scale of genetic disease
Genetic disease is far more common than most people realize, and it is a dominant driver of infant suffering and death.
25% of infant deaths in the NICU are due to genetic disease.
60% of moderate to severe intellectual disability has a genetic cause.
50% of miscarriages are due to genetic causes.
About 10% of the US population — roughly 30 million Americans — has a rare genetic disease, the vast majority of which are genetic in origin, and about 80% of rare diseases are genetic, with half of those affected being children.
95% of rare genetic diseases have no treatment at all, let alone a cure.
About 25% of adults under 40 who show up in the ER for a non-traumatic reason are there because of an underlying genetic condition — a “ticking time bomb” that surfaces unpredictably, like sudden cardiac arrest or, in Siddiqui’s mother’s case, progressive blindness that began in her 30s.
Siddiqui’s own family carries a cluster of genetic conditions including celiac disease (her sister and father), arthritis, gout, and other autoimmune problems, as well as lupus in one of her aunts. Her sister went undiagnosed with celiac for years, coughing through the night as a young child, and the family’s food was restricted — no gluten and also vegetarian — making childhood meals “not awesome.”
What embryo screening actually does
During IVF, multiple embryos are created, and clinics currently choose which one to transfer based almost entirely on visual appearance under a microscope — a method so subjective that studies show the same embryologist will grade the same embryo differently if the image is rotated. Orchid instead sequences the full genome of each embryo, enabling parents to:
Screen for thousands of monogenic (single-gene) diseases that previous technology completely missed.
Calculate polygenic risk scores for complex conditions driven by the cumulative effect of millions of genetic variants, including heart disease, schizophrenia, bipolar disorder, celiac disease, and diabetes.
Compare embryos quantitatively — for example, reducing relative risk for heart disease by 30–80% depending on the embryos available — with no side effects, since parents were already choosing among multiple embryos anyway.
Siddiqui notes that this is more powerful than many blockbuster drugs: pharmaceuticals that make over $1 billion per year typically offer only a 30–35% relative risk reduction and require perfect daily adherence, whereas embryo selection can exceed that risk reduction with a one-time decision and zero ongoing side effects.
Cost, access, and the path to widespread adoption
Orchid charges about $2,500 per embryo for screening. In the US, a full IVF cycle costs around $30,000 (with medication alone running $3,000–$5,000), while in Europe the same cycle costs about $5,000 all-in and is often fully covered by government health insurance. Denmark’s IVF utilization is nearly 10% of all births, compared to about 2.5% in the US, largely because it is subsidized.
Siddiqui believes the main barrier to scaling is not cost but awareness — most people simply don’t know embryo screening is possible. She draws a parallel to fetal alcohol syndrome: once people learned drinking during pregnancy caused harm, behavior changed. Now that parents can learn their embryo’s genetic risks, she expects a similar shift.
She does not think every baby will be screened — over 50% of US births are unplanned, and some people will always conceive naturally — but she believes the fraction of intentional, genetically optimized births will grow steadily.
Eventually she expects governments and insurers to cover both IVF and embryo screening, since preventing a single NICU stay for a genetically compromised infant saves enormous costs. IVF is already heading toward coverage in California and potentially nationwide.
Trump has recently called himself the “father of IVF,” which Siddiqui welcomes as a way of bringing national attention to reproductive technology, even if the claim is not factually accurate.
Patient-led growth and the “wall of love”
Orchid’s growth has been driven almost entirely by patients demanding the technology, not by top-down sales to clinics. Siddiqui herself was the first customer — she screened her own embryos at Stanford and then brought her report to friends, who wanted it for themselves. That personal referral chain became the company’s entire early growth engine.
Today, Orchid is available at over 100 IVF centers, and in at least 70–80 of those, it was patients — not Orchid’s sales team — who pressured clinics to offer the service. Patients walked in and said they would not do an IVF cycle unless they had access to Orchid.
Siddiqui sees this as uniquely powerful because IVF is one of the few areas of healthcare where patients pay out of pocket and can “vote with their feet.” In most of healthcare, someone at an insurance company or HR department decides what’s covered, and patients have no direct leverage.
The company’s website features a “wall of love” — a page dedicated to baby photos and testimonials from families who had healthy children after using Orchid. Siddiqui started the company because she wanted the product for herself, and she believes the strongest possible recommendation is a friend who has used it, can show you their healthy baby, and says, “This worked for me.”
The most meaningful — and most worrying — parts of the job
What means the most to Siddiqui is receiving baby photos from families who had healthy pregnancies after using Orchid. She describes pregnancy as metabolically like running a marathon every day for nine months, and the trauma of discovering midway through — at the 20- or 30-week anatomy scan — that the baby has a fatal anomaly like an undeveloped skull or skeleton. Being able to prevent that by selecting a healthy embryo beforehand is, for her, the most meaningful work possible.
What keeps her up at night is the fear that families who could benefit from this simply don’t know it exists. She wants embryo screening to become as standard a part of family planning conversations as engagement rings are of wedding conversations — something every couple thinks about proactively rather than discovering only after a catastrophic outcome.
The history of moral panic around reproductive technology
Every major reproductive technology in history has faced intense moral backlash before becoming normalized.
Condoms were banned under obscenity laws in the US until two Supreme Court cases — one in 1965 giving married women access and another in 1972 giving unmarried women access. Doctors were jailed for distributing them.
IVF was met with pitchforks and moral outrage when it was first developed; the scientists who invented it eventually won the Nobel Prize, and millions of babies have since been born.
The NICU itself was opposed by doctors who argued that preterm babies shouldn’t be saved and resources should go elsewhere.
Epidurals were opposed on religious grounds — the idea that women should feel pain during childbirth because of Eve’s fall from grace.
C-sections, breastfeeding choices, and essentially every decision surrounding pregnancy have at some point sparked controversy.
Siddiqui sees the current backlash against embryo screening as part of this predictable pattern. She also notes that moral panic is not unique to reproductive technology — people feared elevators without operators, resisted the switch from candles to electricity, and opposed the Golden Gate Bridge. In each case, something was lost but far more was gained.
Sex selection, international differences, and the question of trait screening
Sex selection was once highly controversial in IVF but is now routine in the US, where it’s euphemistically called “family balancing” — a family with two boys might do IVF electively to have a girl. Interestingly, US IVF data shows a slight preference for female embryos.
In contrast, India and China ban sex disclosure of embryos because of strong cultural preferences for male children, which would lead to severe demographic consequences if the information were available. China also bans surrogacy and has historically controlled reproductive decisions more aggressively — including famously arranging for the tallest man and woman to marry so Yao Ming could be born.
Siddiqui believes the next major societal debate will be about non-health traits: should parents have access to information about predicted height, eye color, hair color, or IQ? She thinks this will become a national conversation about what information parents should and shouldn’t have, and she expects Americans’ general pro-freedom, anti-censorship values to shape the outcome, though she acknowledges that people still debate birth control and condoms today.
Siddiqui’s personal genetic lottery and family health
Siddiqui’s South Asian ancestry puts her at significantly higher risk for heart disease and metabolic conditions — South Asians get heart attacks 10 years earlier and are twice as likely to die from them compared to other ancestry groups. Her grandfather had double bypass surgery. This is one of the conditions she cares most about screening for, since embryo selection can cut relative risk by 30–80% and the base rate is already so high in her population.
She herself has tested as not super high risk for heart disease — “won the genetic lottery” there — but notes that even average risk for South Asians is higher than for Caucasians, making risk reduction especially valuable.
Her mother has retinitis pigmentosa (RP), a genetic condition causing progressive blindness. A gene therapy called Luxturna was approved for one specific variant (RPE65) at a cost of over $1 million per eye, but it only prevents further progression rather than reversing blindness, and it doesn’t help the thousands of other variants that cause RP. Siddiqui’s mother had advanced vision loss by the time the therapy existed, so it wasn’t worth the $2 million cost.
Staying optimistic
Siddiqui describes herself as almost pathologically optimistic, comparing hardship to lifting weights — “I got a muscle out of it.” She references Jeff Bezos’s mother saying that if Jeff is unhappy, you just need to wait five minutes. For her, every difficulty in building Orchid became a good story and a source of strength, and she believes that if something is extremely difficult but extremely worthwhile, that’s all the more reason to do it.
