The Fertility Crisis & Ending Genetic Disease w/ Noor Siddiqui, CEO of Orchid

Hey, Upstream listeners. This is Natalie, a producer at Turpentine, the podcast network behind Upstream. This week, we're giving you a throwback to a past interview from Upstream that flew under the radar despite having great discussion. Noor Siddiqui is the founder and CEO of Orchid, the company making the world's first whole genome embryo screen. The episode originally dropped right after Orchid announced their major breakthrough and the release of Orchid to the public. Since then, The first baby using Orchid's technology was born. Elon Musk used Orchid, and Noor has been the subject of much media attention. The conversation ahead offers a window into Noor's thinking during the very beginning of the excitement surrounding Orchid. Noor and Erik cover IVF, fertility, the ethics of reproductive technology, dating, and more. We'd love to hear your feedback. You can email me at natalie@turpentine.co or leave a message to let me know what you'd like to hear more of on Upstream and which guests are most interested in. Please enjoy the episode.

Noor, welcome to the podcast.

Thanks for having me, Erik. This is awesome.

Noor, for starters, what is Orchid and what did you set out to start?

Yeah.

So basically, we had this pretty badass accomplishment last week, which we announced, which is that we built the world's first whole genome sequencing for embryos. So that's a really huge deal because embryos historically have had very little information. So you sequence a really, really small segment of the genome of an embryo, like less than 1%, versus what Orchid is able to do is sequence 99%. So over 100 times the amount of data on an embryo. So like the analogy that I like to use is kind of like a table of contents, um, versus, uh, reading the entire book. So basically you have 23 pairs of chromosomes are organized from smallest to largest. So chromosome 1 is the largest, and then your sex chromosomes are the smallest. And, um, basically what the old school genetic testing did is it just told you, does your embryo have the correct or incorrect number of chromosomes? Which is kind of like, does it have the table of contents? Does it have the correct number of chapters or not? Which is cool. It's really important, right? You'd want to know if your book was like missing an entire chapter. Most chromosomal abnormalities, like having the wrong number of chromosomes, is not compatible with life. So really critical, useful information for sure. But it's really, really low resolution compared to reading an entire book, right? Imagine doing spell check on just the table of contents versus doing spell check on the entire book. So that's really what the massive upgrade is that Orchid's been able to offer. And yeah, I'm just insanely excited about it because within one generation, we have the ability to slash incidence rates for you know, so many major diseases. So right now in the US, there's 30 million people with a rare disease. So it's kind of a really weird dichotomy because it's called rare, because they're individually rare. So individually rare disease means there's less than 200,000 people who are affected. But in aggregate, they're really common. So if you add up all these people, it's 30 million people, it's 10% of Americans have this rare genetic disorder where there's this orphan drug problem where drug companies have no incentive to design a gene therapy or really any treatment for these people, because individually, none of them make economic sense to solve, right? It's sort of like, it costs, you know, $1 billion to bring this to market, you have to do a clinical trial, and there's literally not enough people who are affected versus with Orchid or with basically IVF plus, you know, whole genome sequencing, you have the ability to avoid all of these, you know, thousands of catastrophic diseases at once. So it's something I've been obsessed with for like, I don't even know, I guess like 10 years now, and the company's been working on for several years. So it feels really cool for it to finally be out in the wild. And it's not just— Um, you know, in a research setting, which it has been for many years, it's actually, you know, commercially available. So it's available at IVF centers all across the country. Some cool news about how that's going, hopefully announced in January, but it still just feels like such a big deal to just have it alive.

Say more about going from 1% to 99%. Like, how exactly did you guys do that? And why hasn't that been done before? Why couldn't that have been done before?

I mean, I guess what I would say to other people is like, never underestimate what you can do if you're obsessed with the problem. So anyways, a little, a little bit tooting our own horn a little bit, but basically there's been billions of dollars invested into single-cell sequencing over the last decade. It's just that most companies and people have been interested in a specific problem of whole genome sequencing of embryos, right? So people have been interested in it for, you know, cancer tumor sequencing, blah, blah, blah. And we were basically, I guess, kind of like the best and first team to just obsess over the engineering challenge of, okay, you have, you know, 4 to 6 cells from a trophectoderm biopsy. So an embryo, the outside of it is called the trophectoderm. It becomes the placenta. Those are the few cells that we receive. Um, so we just obsessed over everything from how the embryologist sends us that sample, the buffer, the chemistry that we use, the bioinformatics, the variant analysis, um, the pipeline, everything to maximize the, uh, DNA yield and then the quality of the data that we receive so that we can do this sort of clinical-grade whole genome. So there's that. It's basically just obsessing over the problem for multiple years and basically kind of aggregating a bunch of kind of advances in each of those specific domains. And then I guess the second piece of it is just, yeah, standing on the shoulders of giants, right? There's been a lot of work done and we kind of were able to pull it all together into a specific use case that I'm obsessed with. And it is also more expensive. So when you sequence less, you also have to pay less, right? Because you're— By definition, the COGS on that is lower. So yeah, I guess my feeling, just because of how I grew up— my mom has this condition called retinitis pigmentosa. She started progressively going blind in her 30s. To me, like, seeing her life get totally hijacked, you know, losing her independence from basically this being unlucky, right? Having this typo that, you know, fortunately her siblings didn't have, but she had, just made it— to me, it's like— incredibly inexpensive, right? Because if that's the cost, and it's not just that thing that we're able to screen for, right? It's like thousands of things simultaneously. So yeah, no, I guess it just really just depends on framing. So for, I think for people with a family history, people who have any of these conditions, it's like a complete no-brainer. I think if people are lucky enough to like have a completely healthy, nothing going on in their family, nothing that they've ever even seen a friend have, I think that for them, then it might be perceived as more expensive. But yeah, I think those are the two things, basically willing to go the, like, you know, extra mile from like the engineering and the chemistry and the bioinformatics perspective. And then also like wanting to build the best product, not the most affordable product, I guess. Yeah.

But could this not have been done a decade ago? Like, what was the breakthrough that like enabled this in some capacity?

Yeah. So the other thing that's interesting about a decade ago is that even if you could get a whole genome readout a decade ago, it wouldn't actually have been that useful, right? Because over the last decade now since sequencing adults, right? Because blood and saliva, you know, you have a lot more DNA, like in a sample than you have in, you know, a few cells. So even as like, just sequencing has gotten cheaper and more of a commodity, these databases have gotten larger where you can say, okay, this typo causes this disease. And you kind of get more and more evidence for that as more people have that specific typo or variant alteration. So yeah, it's actually kind of crazy, right? It's sort of like you have to have a confluence of so many different technologies, all of this stuff has to aggregate over Yeah, literally 2 decades since the Human Genome Project even emerged for this to be useful, right? Because yeah, totally. I think 10 years ago, if you had a whole genome, then you didn't really have very much actionable stuff that you'd learn about it. So for the monogenic conditions, there wouldn't be as many that we know about as we do today. Right now, we know about neurodevelopmental disorders like epilepsy and autism and cancers and pediatric onset cancers and heart defects and skeletal defects and so many different things. And then you also, obviously the polygenic side is, I think, is another really exciting development of It's not just a single gene that causes the disease, but it's the cumulative effect of, you know, millions of variants where it's more of a, you know, machine learning, like risk score, as opposed to a, like, yes or no, this embryo has this, you know, specific typo that, you know, we know is going to cause a disease that is not very fun to have.

Let's give more background to people who are kind of new to the, to the, to the science of this, I guess, say more about the impact or significance of the, of the polygenic scores, or just like how it works in terms of, you know, sort of multiple genes or one gene, etc.? Why don't you give just a bit more background for people to kind of wrap their head around?

Yeah, I think like a really approachable example that people know a lot about is probably like BRCA or breast cancer, right? So there's like a single gene, BRCA makes you, you know, much more likely than the average person to develop breast cancer. I think certain variants, you're talking about like a 70% plus lifetime risk. So that's one gene. that makes you much more likely to develop a disease. So that's monogenic form. And then the alternative is that you have a polygenic score. So for breast cancer, there's also polygenic scores, which means that you have millions of variants. You have like a model where you have hundreds of thousands of people who've been sequenced, some of them who have labels that say, okay, they got breast cancer at one age. And then you build a model that says, here are the variants that increase your risk for breast cancer. So I guess kind of the way that you can think about it is like, one thing is like, very interpretable in the sense that you have it or you don't, right? You have this specific monogenic variant or you don't, versus you have a risk score, which is telling you you're, you know, 3 times, 4 times, 5 times as likely to develop the disease compared to the base rate. So I think the base rate for breast cancer in the US is like 12%. So basically the highest percentile of the polygenic risk score, maybe if you're in the 99th percentile of risk, you might have like, you know, 4 or 5 times the risk for breast cancer, which doesn't, it's not as intense as having the BRCA mutation. So the reason why I was hesitating a bit on this example is that it's not quite the best example because BRCA is still a predispositional gene, right? It's not a diagnosis of a disease versus I would say the most canonical example of a monogenic condition would be something like Rett syndrome or cystic fibrosis or something like that, where having that gene means you have that disease. Yeah, it's not, it's not this like risk score, right? Where it's kind of like smoking, where if you smoke, you're not guaranteed to develop lung cancer, it's sort of like a modifiable risk factor. So I guess like to put it in context, I think for lung cancer, if you smoke like 5 cigarettes a day, I think you have like an 8% chance of developing lung cancer by age 80 or so. So I think that's actually, I think, a kind of good thing to put in context because, you know, smoking, everyone agrees is really bad, but it actually is only like 10 to 15 times the base rate of developing lung cancer. I mean, not to say that 10 to 15 is low, but that lifestyle intervention intervention is on par with some of these polygenic risk scores. So type 1 diabetes, you know, that's something that you get diagnosed with, uh, like under 10 years old. And the polygenic risk scores for type 1 diabetes are, you know, around, um, you know, 15 times the baseline risk of the disease. So I would say TL;DR, the difference between monogenic and polygenic. Monogenic is if you have this gene, you know, you have that specific syndrome or condition versus polygenic, um, is a much newer type of testing that's that's more quantifying your risk, quantifying the genetic component of your risk in the same way that lifestyle factors like smoking is not a diagnosis of lung cancer. It's a risk factor that you should be aware of and like probably try to, you know, pull the cord on. Like, I think everyone agrees you shouldn't smoke. It's kind of a bad idea.

Yeah. Continuing sort of the definition of terms and background here, another thing that really enables this is sort of the growing popularity of IVF. Why don't you give some background there as to What is IVF exactly, or how does it work? Why has it gotten more popular? You know, what's the significance of it, et cetera?

Yeah, IVF is so cool. I don't know. I just like the first time I went into an IVF lab, I thought it was the coolest thing ever. Like, you literally come there and there's like, this is a place where they make humans, right? Like millions of people owe their existence to IVF. They wouldn't exist today because of it. Uh, but yeah, I guess like context on IVF, like IVF is like traditionally used to treat, um, Uh, infertility, right? So like, I think everyone we know, most people like want to have kids later in life. So I think the average age of a first-time mother in San Francisco is like 33 or something like that. And a geriatric pregnancy is 35, right? So basically the condition for everyone is to become infertile, um, over time. And basically as we've, you know, pushed the age where we want to have kids later and later, the set of people who are infertile or have some sort of fertility issue happens earlier and earlier. So I think a lot of times there's a lot of blame that's put on women of, oh, you know, they're the reason why, um, They have the couple has to go through infertility. But if you ask fertility doctors, they usually say something like the attribution is like a third, a third, a third. So a third is female factor infertility, a third is male factor infertility, and a third is unexplained. I feel like that's probably the least satisfying of like, we don't know why you're here. Everything looks fine, but you know, you need to do IVF. So yeah, that's like the set of folks who are doing IVF right now.

Yeah.

And I think basically maybe my controversial or like hot take is just that, you know, sex is for fun and IVF is for babies in the future, right? Like since everyone's already Planning more, um, you know, freezing eggs is like the exact same thing as freezing embryos. The only difference is that if you freeze eggs, you're not doing that final step of fertilizing and creating embryos. Um, so basically people are already electively freezing their eggs. People are already electively, um, doing IVF for things like, um, you know, wanting to, you know, balance their family. So they have like, you know, 3 boys and they want to have a girl finally. So people are already electively, um, doing IVF. People are already electively doing egg freezing. And I think that A much more legitimate reason to do it is that you want to minimize the chance that your, your child has a, you know, horrible condition, right? Like these are things where, you know, there's babies that don't live for the first year of life. They end up in the NICU. There's no treatments. There's nothing that we can do to save them. I mean, yeah, I guess kind of a controversial or like spicy take would be that, you know, it would be, um, you know, irresponsible not to get this information and, um, let your child have a condition that you otherwise could have prevented. So. I don't know. I think that's maybe a little, maybe a little spicy for folks right now, but I think it's a really cool and I think sort of unstoppable future, right? Like, I think we might hesitate a bit as, um, you know, I think that the fertility coverage in the US isn't as good as it should be, right? In other countries, it's a lot more affordable than it is in the US. It doesn't have to be as expensive as it is here. But I think, you know, I think that would be like a really amazing end state, right? Like we moved from home births to hospital births because it, you know, helps You know, maternal and fetal mortality. And I think that hopefully, like, I mean, you know, this would be like a similar level of benefit to families is that, hey, there's this like huge category of conditions that we don't know how to cure, we don't know how to treat, but we do know how to detect at least. And like, let's detect it at the absolute earliest stage where parents can actually intervene and, you know, make a difference and, you know, have a healthy baby.

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It's fascinating, this idea of sometimes when a thing is introduced, it's immediately stigmatized. But then, as you kind of indicated, what might happen here too is it's stigmatized, like, not to do it. And so I don't know if birth control or condoms followed that similar sort of path, but there certainly are a number of inventions that in the beginning people thought, oh, this is crazy, people won't do it or they shouldn't do it. And then to not do it, or, you know, self-driving cars perhaps is another example of people are trying to stigmatize it now. But once people kind of intuit how many deaths it prevents, you know, it would be stigmatized to not use an autonomous vehicle. Talk a bit about the ethics behind it in terms of, you know, sometimes people get scared at like, oh, we can remove diseases, but that also means we can do lots of other things as well, or will be able to in the future. And so they're scared of the slippery slope. The slopes are often slippery in the full context of time. So talk a little bit about some of the concerns you hear and how you address them.

Yeah, no, I think stigma when it comes to reproductive technology is massive, right? Like people were incredibly secretive, you know, the first IVF babies, they were just like absolutely didn't want anyone to know. So yeah, IVF was, was, you know, something people are incredibly ashamed to do in the beginning. And now it's been totally normalized, which I think is awesome. Birth control was incredibly stigmatized when it first came out. I think that, um, the first birth control, um, you know, was just completely shut down. It was marketed as, um, you know, something that would help, you know, ease like menstrual cramps, that it was like side effect is that, um, you know, you know, you won't be able to, uh, you know, this, the side effect is what was actually was, was that, okay, you know, this will lead so that you can have more control over, you know, when you get pregnant. But it was, couldn't even be marketed, uh, outwardly that way. And that women, uh, it would, it was only then it was only allowed to married women and then married women had to have like the signature of their husband in order to use it. So Yeah, reproductive technology has always been hotly contested. The stuff that we think is completely normal today was like fought for, unfortunately, years or decades and is like still fought in certain places. I mean, we're seeing that now with the debates around surrogacy. I mean, people are— surrogacy is now under attack, you know, egg donor, sperm donor, all of these situations are under attack. I personally know friends where, you know, there was a female partner. Um, I know the female partner and she didn't want to use a, um, sperm donor database. She wanted to use a friend who was a gay man. And, um, because he was a gay man, they were required to go through like extensive psychological screening to, um, you know, allow that, uh, embryo to be created when A, she could just go get knocked up any night at a bar and B, she could just buy any sperm that's available on a, you know, sperm donor website. But specifically because he was a gay man. And, you know, for whatever reason that triggered all this, you know, I just find that incredibly condescending and sad that, you know, in 2023 in, in San Francisco, that type of stuff is still going on. So yeah, I think there's a huge amount of stigma around reproductive technology. And I think specifically, I mean, my stance around the ethics, I think I kind of already revealed, right? Which is that I think parents have an obligation to do everything that they can to have a healthy baby. And, you know, we see people doing that constantly, right? Like they're, you know, obsessed with how do I get my kid to the Um, best schools? How do I give them, you know, the best food? All this stuff. And like, if you think about it, those are really marginal in terms of what, what effect that is going to have on the child's life compared to, you know, do they have a like lethal skeletal dysplasia? Do they have, are they born without a limb? Are they born with, you know, really aggressive pediatric cancer? Like these are all things that parents can now know about and screen for before they're pregnant. And I don't know, I just personally, I feel super strongly about it. Like the idea. I think abortion is like a super hot and charged topic. I'm personally, you know, pro-choice. I think women should have the right to choose, but I personally wouldn't want to have to, you know, go through with an abortion. I think physically it's just physically and emotionally it's really, you know, tough on, on your body. And I think that it's like a really exciting avenue to try to be able to avoid that, right? Is that if you can screen for all these anomalies that could occur during a pregnancy, you can avoid a miscarriage, you can avoid having To you know terminate you know pregnancy that isn't going to actually come to term and avoid all of that psychological and physical you know harm to your body, right? I mean pregnancy is like just such an incredibly intense thing. Like it's literally the most metabolically intense thing any human man or woman does, right? So like your maximum metabolic rate is something like I think 2.5 or something. And if you do a triathlon, if you do an ultra marathon, so not just a marathon, like an ultra marathon, like multiple days. You can only sustain that for, you know, something like, you know, 30 days or something like that. And that's like the, like, limit of, like, what the physical expenditure people do. And pregnant women do that for 180 days, right? It's like they are at the maximum metabolic limit for 180 days. And, um, yeah, so I think, like, that's a huge investment, right? And that's just the beginning of the investment, right? Like, you're going to raise that child for 18 years. And yeah, I don't know. I mean, if as a kid, I like, you know, felt, you know, sad that my mom, you know, went through this thing that most people would say is super mild, right? Like, oh, she, you know, had normal vision for, you know, most of her life and then only had this happen to her later. You know, I think that the amount of like love and care that a parent has is probably, you know, 10x, you know, what a, what a kid has, right? It's sort of like they're like an extension of you. So yeah, for me personally, it's like I would, yeah, I would like definitely wanna make sure that I would, that I had that information. You know, before pregnancy or before I had kids. And I think in terms of for other people, I think my general stance on it is just that you shouldn't dictate to other people what to do. Like they should have choice, right? So in terms of embryo screening, it's, I think it's a parent's right to have whatever information that they find useful. I think our responsibility as Orchid is to make sure that that information is, is accurate, right? So we spent an enormous amount of time to make sure that this data is the highest quality data that you could possibly get. We spent an enormous amount of time. curating the variants and the genes and the diseases that we include. These are only super serious and severe monogenic conditions that, you know, you definitely want to know about. You know, the polygenic is kind of the best scores that we could find and benchmark that work as well as possible across ancestries. And we want to make sure that counseling is really comprehensive so people understand what's, you know, what data means what. But I think that's kind of where, Orchid or any company's responsibility sort of ends. It's sort of like you should present the data as honestly as possible, and then the decision about what to do with that information or whether to even request that information, I think, is like fundamentally a parent's choice.

Say more about the concern that some people have around sort of the Gattaca future where parents try to create their perfect children.

Yeah, I don't know. I think it just depends what you define as perfect, right? I mean, I think that it's an insane upgrade to be able to have a healthy life, right? Like, so many people's lives are, you know, they would self-describe as destroyed or derailed by, you know, some serious illness that they have. So, um, yeah, I think it just depends where, you know, where society draws that line, right? It's not really fundamentally, um, you know, Orchid's decision how to censor information. Like, to me, like, the motivation that I have and like what, what I think is like an super exciting future is like one where, you know, pretty much, um, anyone who wants to have a kid, regardless of what disease they have, their partner has, is able to have a kid and has, um, the ability to, you know, have the best chance at that. I think all this other stuff is like kind of noise, and I hope it doesn't like, you know, pull the field back. But, um, like fundamentally, it's not really Orchid or any individual's company decision. It's really a societal decision, right? Like, you know, we could choose to You know, censor certain information that we think parents shouldn't be selecting on. Um, you know, plenty of countries have done that, um, with something with, with sex, right? So sex is reported on embryos in the US, and it's not reported on embryos, um, in China, India, and a bunch of other countries. So yeah, every society, every government can choose, you know, what information that it wants to provide parents and what information shouldn't be provided. And I don't know, again, my stance is is just that there's so much benefit here, so much benefit, I think, in pole on the health side that, yeah, I think the other stuff is kind of icing or just not as interesting. But what do you think?

One thing I think is interesting is just that we're not willing to really be honest with ourselves in a number of ways. Take longevity, for example. We're very interested in curing all sorts of diseases and all this money towards cancer or diabetes or Or, you know, extending lifespan in all these sort of incremental ways. And then when a group of people, you know, suggest ways that we could sort of solve those problems more at the root in a more fundamental way and in a more perhaps effective way, people get terrified and scared and think it's like, are we trying to expand lifespan or are we not? Like, at what point would we no longer be comfortable trying to do it in an incremental way? And it feels like Here's just another version of that where, of course, people, you know, we want more healthy babies. And so what's the problem?

Yeah, no, I mean, I think that there's like these really weird false dichotomies at play. People think that somehow you having a healthy baby damages them and their identity, right? Like, I'm obviously super pro, like, my mom's condition, like, you know, RP, I want there to be lots of therapies and lots of money poured into Curing that, like for however many more years my mom gets to live. But that doesn't mean that my mom or me or anyone else really wants to have a child that's going to go blind later, right? So I think there's this weird kind of like like limited thinking where if fewer babies with conditions are born, that's somehow going to affect current people. Where you know where I think the opposite is actually true, right? Currently we're spending currently we're wasting billions of dollars that that could be redirected, right? If if the next generation is healthier and doesn't have these conditions, then we can put more money. Into you know developing cures for the people who are already available. So it's not the case that having less disease in the future somehow damages or diminishes people today. So I think that's kind of like a weird false equivalency that happens. I think is weirdly is is actually very bizarre and sad, right? Because you'll actually see the advocacy groups like it'd be like the American Cancer Society saying like hey let's have more cancer, right? So I think it it comes out of fear and it comes out of Again, stigma, right? People being worried that their identity is being stigmatized because, you know, parents are selecting to avoid that disease in the future. And I think that, I don't know, I just think it's like kind of weird and backwards, right? Like if a parent doesn't want their child to suffer in the same way that they do, you should let them. And I don't know, it just seems like I kind of feel really angry that people would want to limit a parent's ability to do that, right? Like, why would you dictate to me, no, your kid has to go blind? Like, that's insane. Like, why? If I can do something to make that even 1% less likely, I should have the They have the right to do that, and everyone should have the right to do that.

My understanding is that like 100 years ago, it was like a left-wing thing to be into eugenics, or like the idea that we can make better people. And I think it was like a left-wing or progressive cause with the intent to help out sort of the worse off, like, and their future kids. And they were seeing like growing inequality, and it was like, hey, we can, we can make a difference here. And then I think World War II really, Germany really just like ruined it for everyone, like in perpetuity, because they saw sort of like someone tried to sort of, you know, eliminate, or sort of like, you know, a race or a couple races of people. And thus anything that even has like the stench of trying to sort of improve things, sort of, you know, at birth, people get scared that that can be used in very hostile ways. Is that, is that your understanding too? Or, yeah, how do you react to that?

Yeah, I think I just like really strongly and vigorously reject any association with that because I think it's actually fundamentally the exact opposite, right? So, um, giving parents the ability to have this information, um, is their choice. They choose whether or not they want to do IVF. They choose whether or not they want to have The information and they choose what they want to do with the information, right? And the people who stand to benefit the most are the most vulnerable, right? Like people like me or people who have any of these conditions, they're the ones who are freely choosing and electing, hey, I want to do this so that I can, you know, improve the chance that my child isn't affected, which is the exact opposite motivation of, you know, a government coming in and basically deciding, hey, you're fit to reproduce or you're not fit to reproduce. You know, forced sterilization is literally the exact opposite of that. This type of service is saying, regardless of you know any health issue that you have, now you can choose to you know not pass that on or have the potential to not pass that on to your child. So it's like the exact yes. Basically, I think it's like this like really weird thing in society where like I don't know you just do this like nearest neighbor search and then you kind of like attach to all those random ideas without actually understanding like what is this what is this no novel thing and how does it actually impact people? And I think that's weird. I mean, it's, I think it in one sense is a really good impulse because obviously like babies and pregnant women are really vulnerable and they should be protected and there should be like intense interest on making sure all of that is as safe as possible. But I don't know. I think like this specific specter is like just really depressing because they're, they actually are coming from the exact opposite place. One is like, government controlling what people do and saying who should and shouldn't have kids. And this, and this is the exact opposite. It's saying that regardless of, you know, where, um, you know, where you're starting in terms of a specific condition, you should be able to choose and make every decision about and have like reproductive autonomy and reproductive choice. Um, so it's, it's actually very bizarre to me that they, that they are lumped together when they're the exact opposite.

Yeah. Let's go beyond Orchid and now, now just talking like future speculation here. Let's say 30 years from now, when our future kids will be having kids, or maybe even 40 years from now, like, how are they going to have— like, what are the norms around having kids going to be? Is it going to be like radically different, like sci-fi different, like they have, you know, a ton of influence over the makeup of their kids, even kind of beyond their own existing genes? Or is it like— What do you think that might be like?

I hope it's way better. I mean, I think that it's, yeah, I think reproductive technology has like kind of stalled, right? There hasn't really been, I would say, like a really big upgrade since IVF. I mean, you know, compare that to other fields where you see, I feel like, a lot more interest, a lot more funding, a lot more progress. So yeah, I would really hope that there's like a lot of cool new stuff. I think like the 2 things that like I'm personally like most excited about, I would say, are in vitro gametogenesis. So like making egg cells and making egg cells and sperm cells from skin cells. So that would basically obviate the need for IVF to be invasive. You can kind of generate arbitrary number of eggs and embryos. So I think that's— there's fortunately a couple of like pretty cool companies that are working on that. And I think hopefully that'll be, you know, in market maybe in 10 or so years. And then I think, yeah, artificial wombs is also like super cool, right? Like we were just talking about how like metabolic metabolically expensive pregnancy is and how, you know, women currently have to like kind of make this really difficult choice of like when do they want to take that, you know, 9, 18, you know, however much time they want to spend, um, you know, bonding and, you know, doing all the baby stuff with versus, um, you know, working on their careers. And I think that, you know, if we can get artificial wombs, um, online, I think that'll, um, you know, that'll help a lot of women. And again, it's not about saying that everyone has to use that or has to do IVG. It's just like Creating more choice and more options for people to have kids, right? Like we're currently in this state of population collapse, right? You know, I think South Korea has like one of the lowest fertility rates in the world. Their population is going to drop by like 40 or 50% because there's like, you know, I think it's like one or might even be below one, you know, baby being born per woman in, um, in South Korea. They spent like, I think over $200 billion trying to get that number up. And it's like. You know, I mean, it's not just reproductive technology that's leading to falling fertility rates, but if that's any piece of it, which I think most people would agree it is at least some part of it, um, you know, I think we should be, uh, making that whole process easier, right? Like, there's still people who die in childbirth. Like, that sucks, right? Like, why don't we make that number zero? There's still, um, so many complications to, you know, both the, um, you know, person giving birth and to The baby that, um, yeah, I don't know. I just feel like it should be like the subject of like intense discussion, right? I mean, how are all of the humans being created, right? Like, don't we care about making sure that's, um, you know, it's like, yeah, it's just, it's just such a fundamental part of life, um, that, uh, you know, yeah, I hope there's like some sort of meme or just like, uh, explosion in like interest and obsession with making it, um, with making it better, right? I mean, everyone cares a lot about their kids. And, um, hopefully cares a lot about the, the, um, you know, the humans making the kids too. So yeah, I hope, I hope that we continue to see like super impressive advancements, like in, in that whole space.

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Yeah, let's actually segue to population and, and sort of the state of fertility a little bit, because when people talk about why we're having less kids on average, some people, you know, mention, uh, the cultural impacts, you know, just modernization, the opportunity cost is, is much higher. Um, you know, women and, and men can just have, you know, more fulfilling careers and, and don't need kids for, for their careers. In fact, kids can be a burden. You know, hold back their, their, their, their livelihoods or economic livelihoods for, for a certain number of years in ways that they don't in, in developing countries or, or in the past. Um, so some point to, you know, cultural, others point to technology as, as we were just talking about of, hey, you know, if, if there was better, if there was artificial wombs or if there was, uh, you know, better sort of, uh, fertility technology across the board, maybe it'd be easier. Um, but some then people then say, hey, it's not, necessarily about having the kids. It's also about raising the kids and being able to, to not only want to do that, that's a culture part, but also be able to afford to do it, like have, you know, housing and schooling and all the things that are required to raise kids be not crazy, you know, expensive. And there are different countries that have tried to, you know, sort of increase fertility rates in different ways, whether it's tax credits or advantages or subsidizing some of these, you know, things like daycare and other sort of economic gains or economic needs. But it seems like they've had little impact in meaningfully increasing fertility. What is your reaction to some of these issues and some of these thoughts around, or what are some of the causes as to why we're having fewer babies and what are ways in which a society could meaningfully increase that.

Yeah. I mean, for whatever reason, what's coming to mind right now is that image on Twitter that's been circulating, which I think is from the Marriage Pact, which talks, which is like this really funny graph, which shows how are people meeting. So it was, it kind of like compares all the old ways people used to meet, which is like through church or through friends or through school. And like all of those are crashing and then like meeting online is like You know, through the roof. And it's like basically how something absurd, like 80 or 90% of people are meeting. So I don't know. I just feel like these shifts somehow, somehow just become a meme and like flip somehow. Right. Like it used to be not even, I would say 10 years ago, maybe like 5 or 6 years ago, it was like stigmatized to meet online. It was like, oh, like you can't meet people in person. Like, why are you so weird? Like, you know, and now it's the opposite.

It's like, yeah, it's another great example of the stigma shifting.

Yeah. And it's like, it just, it was just a complete flip. And like, I think you saw a similar thing with mined diamonds versus lab-grown diamonds, right? A few years ago, it was something like 90% of loose diamond sales were mined diamonds, right? And then there was all this stuff around environmentalism and it's like, oh my gosh, why would you want to mine? That's horrible. The lab-grown ones are larger and more clear and all this stuff. And now I think over the last 3 years, you've seen this flip where it's like, I think something like 50/50, like lab-grown diamonds are now about to eclipse, uh, mined diamonds, um, in terms of, uh, sales, right? It used to be the stigma of like, oh, well, why, like lab-made is like somehow inferior, right? So I think that, um, yeah, it's like a similar stigma, I think, with maybe, um, embryo screening and IVF. Like right now there might be this like, oh, you know, that's too much information or whatever. And then I think at some point there's just going to be this flip of like, why would you not want to get that information? Why would you risk these conditions? And maybe it'll similarly be that way for babies, right? Where like, for right now, there's like some sort of meme going on that's like, like having a child, you know, somehow like reduces your freedom or optionality or like people aren't meeting early enough or whatever it is. Like, I don't, I think, you know, maybe it is kind of interesting how it's so global, right? It's not just, I think that that part is pretty crazy. It's like somehow this meme has like spread everywhere except for like a small number of places. I think there's like some insane stat, I think of like Nigeria, I think, is still at like 6 or 7 kiddos per woman. And so like that, the population of Nigeria is going to, which is like the size of like, I don't know, a very small fraction of the US. I think it's like, you know, maybe the size of like Texas or something is about to have like 300, not about, but 300 million people are about to be, you know, exist in Nigeria because the, you know, their, you know, population curve is just accelerating so much faster than the US is. And it's just, it's kind of crazy, right? Because we kind of like have all of our society built on This assumption that's false, that there's just going to be like infinite new babies born who are going to like be workers and like pay into the system. So I don't know; it's kind of crazy, right? Like you're—it is sort of a slow demographic shift. But you know, like populations like Japan, populations like the U.S., like you're like in not too long you're going to see like twenty or thirty percent of people with dementia, right? Like that's insane. Like how do you have us? Like I don't think our society could really hold together the way that it is right now with that fraction of people. Um, you know, with that level of, you know, mental, um, impairment, right? So I think that, I don't know, it's like, it's a crazy situation. I mean, I applaud what you're doing. You're doing your matchmaking stuff. So hopefully that helps people, more people get together and have babies. And I don't know, what do you think people should do or society should do? Or what do you think's going on?

Let me tell the audience. Uh, so yeah, I'm working on this, uh, with a couple friends, this sort of matchmaking sort of pool, almost like an OG Hinge of people just meeting via friends of friends and friends. And the irony is that it feels like middle school where it's like a lot of people who know each other, but once they realize or know of each other, once they realize that one other person, that one of them likes each other, then they'll like them too. And so we're just like helping them realize that. And it shows to like, you know, people are kind of just scared to put themselves out there.

I think it's a really amazing thing, by the way, just to, like, I don't know, be a little bit South Asian about this. Like, in the South Asian community, I think there's like, people feel bad for other people, right? Because in South Asians, it's like your parents, like your whole family is involved in like matchmaking you for better or for worse, right? So I don't know. I think the perspective from, you know, that community is like, Oh my gosh, it's so lonely. It's so hard. Like you have to do it all by yourself. So to me, this is like a very obvious, amazing service, right? Like, you know, we need Eric and, um, you know, friends matchmaking people. I feel like it's like what brings you the most happiness in your life, right? It's like having an amazing partner, having an amazing family. So it's like, I don't know. I think that it's underrated and I think he deserves way more applause and, um, you know, fanfare for this matchmaking stuff because literally even if Even if one couple comes out of it, even if one baby, I mean, that's amazing. Like, that's like so cool.

Yeah. Well, I heard if I get 3 couples, then I go to Jewish heaven. So that's, that's, that's enough motivation for me. But yeah, no, we're excited to launch it pretty soon.

How are you matching people, by the way? I never asked that, actually. What is the algorithm? Is it like, do you do interviews or like, how does it happen?

No, no, no. If it was a business, at some point we want to turn it into into something that's more sustainable. Right now, it's literally just OG Hinge. We curate the people that come in, and then we give them the sort of list of people who are in the community. And if they both pick each other, then we match them over text. And we do it over text because we want to increase accountability. So no one can ghost. If you ghost, you get kicked out, basically.

Nice. I like that. That's really good. That's really good.

And we have vouchers. So we give them, like, everyone is referred to either by us or someone else in the community and like why there's like higher context when you meet the people and there's like accountability via being part of the broader group.

So I feel like, I feel like the idea of exclusivity is really important for these matchmaking things. I feel like that like really changes things. So like, how is that, is that hard? Are you disqualifying people and being like, sorry, you're not the right fit? Like, how do you do that?

Yes and no. I mean, once we're public, we're gonna do it in, in, in like a much at higher scale. But yeah, right now it's just, you have to be vouched for by someone in the, in the community. And, you know, people's vouch is kind of like on the line. So yeah, it's, there's a few people we've just had to give like a weird answer to like, hey, get, get a vouch or that vouch isn't like good enough.

Yeah. You have to, you have to lay down the law because these are, you know, people's lives are on the line. So that's what you do. Yeah, exactly.

But at some point there is someone for everybody. So at some point we'll be able to do a better job of like tiering or whatever. But yeah, it is interesting.

Have you been surprised by the couples? Like, are you developing this intuition of like, ah, this is like the magnetism that like makes an amazing—

Well, I will say I'm a little white-pilled. Like, I'm previously, I was black-pilled on dating apps. I thought that because you see the stats and you're like, oh shit, a very small amount of men get all the women or get 80% of women or whatever. And like, you know, there's just like an insane power law. But actually, it's more diverse than I thought. Like, people— not everybody has the same taste, which is something that I think most people intuitively think. But then if you study dating app data, you're like, wow, this doesn't look like that. But so, so far, I've been pleasantly surprised at how more people are willing to match with more people than, than I thought or imagined. And that, that is promising.

Yeah, I feel like everyone always has like their own insecurities and hangups, right? Like, The engineer's like, oh my God, I really need like a salesperson to be able to like sell my thing. Otherwise no one's gonna want it. And the salesperson is like, oh my God, I really wish I had an engineer to build my app. So I think it's the same thing. It's like, you know, we're all like sitting in our bubble and we're like, no one's gonna wanna date me. But then they actually do. That's so good. I'm so glad to hear that. It's amazing.

Yeah. Like I have a few friends who are on it and I'm like even surprised they have way more interest than I would've imagined.

Oh, burn, burn. That's so mean. You're like, I wasn't even gonna let you on. I wasn't even gonna be your vouch. You had to get in through like a third. Person. It's amazing.

And a lot of it's just asking people out, or like, yeah, people want to be asked out, I guess, or certainly women do. And men, you know, don't want to do all of it, or not all men want. And so a lot of it is really just this like coordination challenge where someone's like, I would be interested if people do XYZ action, you know, i.e., if the man is like more forward, but the— or whatever, does it in the right way. but the man either doesn't want to do it or is scared to do it or doesn't know that it would be received well. People don't want to be rejected, right? So it's, um, it's a fun— and this is why it's helpful to have other people involved, whether it's friends or families or whatever, to like lubricate the interaction. No, you know, that was a bad, bad, uh, word to use, but— In this instance. Um, but yeah, I, I think, I mean, the broader thing around matching is just that like 60% of women are college students or whatever. And, you know, women don't date down. Like a college-educated woman isn't going to date a non-college-educated man, you know, kind of on a general— to generalize. And so there's just like not enough men who meet women's standards. And so either women have to change those standards— that's not going to happen— or men have to like rise up And we have like inequality, um, at the median, you know, um, but is that gonna happen unless there's like social engineering? I don't see that happening. Or—

So do you, so do you think the decline of men is real like that? All those headlines, do you think it's true?

I think it's on the median level. It's, it's, it's happening. Not, uh, you know, men, Larry Summers said this like 10, 15 years ago. He got slaughtered for it, but he is like, men are at the top of society and are at the bottom of society. Like there's just way higher variance. Um, and so like, Men are CEOs of the companies, but they're also in jail. They're also the people who are doing the absolute worst. But then also at the median level, at the very least, the college data is hard to deny. And there's probably some accompanying data around women who are college educated not willing to date or marry someone— not willing to marry someone who's non-college educated on average or whatever. I think the decline of men, like, at some median or middle level is real. And I don't know, and women not dating down seems real and seems reasonable. If you're, you know, you want the best genes for your kid to bring us back full circle. And so I don't necessarily know what to do about that. But that seems— that seems— I mean, it does seem like you're seeing more women want to, like, raise kids with their friends or something. Or even do the, like, have kids with Elon or something like, like, be willing to accept. And I mean that as a metaphor, be willing to, like, not need one stable father. Like, I wonder if that's going to be a more popular solution. Like, basically just what's happening on dating apps happening with having kids too, in that a fewer, you know, smaller percentage of men are having more of the kids. Like, I'm actually surprised. Why doesn't Elon have, like, 100 kids? Like, he can afford it. It's like the biggest problem. Um, you know, he already has 10 or 13 or whatever it is. He's not going to spend enough time with them. Why not like make a statement and just have like 100, Genghis Khan style? What do you think about putting aside Elon? Like, if you were someone who is dedicated to increasing the fertility rate, is having dozens like an insane idea?

I don't know. I mean, I think, um, I think people have like usually pretty like strong opinions about how they want to raise their kids, right? People are like, you know, if they were an only child, they're usually either like, oh yeah, that was great, or they're like, I really wish I had a sibling. Or if they're, you know, one of 3, or if they're one of 4, you know, they usually have like some reaction to how they were raised. And I think that probably, I think for most people, having that many kids is like out of the bounds of like weirdness that they would want to, uh, tolerate. But I don't know. I mean, you know, you have less Parental love, but you have way more sibling love. So like, I don't know, I think it might be, you know, it might be, you know, hard to argue which setup is better. I think that like there's people who've— I think it's really just hard to like draw conclusions without having like way more specifics about like, well, how are you going to raise them? And like, who are the parents? And like, you know, are they, you know, how want— are they doing it to like, you know, hold some like Guinness Book World Record? Or are they doing it because they, um, You know, they really like love kids and like want there to be more of them, right? Like, so I don't know, it's, it's hard to draw something specific. Do you, do you have like a specific number in mind or you're like, I want to have this many kids this way by this date? Like, do you have a timeline? Like, what are you doing to contribute to the fertility collapse problem? I know the matchmaking thing. Matchmaking is more than most other people are doing. And I want to, you know, help with that as much as possible. I think it's really cool. Um, but that's more of like a bucket list thing for me. Like, I feel like I would just feel so happy if I was responsible for even one marriage. I feel like that's just so cool. Like all these. You know, dating apps are like, they're literally reshaping the next generation, right? Like, that chart shows it all, right? Like, you see this massive— they're deciding the algorithm, they're deciding all the couples. But yeah, I don't know. What do you think?

I mean, I'm probably gonna have like 2 or 3 kids. Who knows? Maybe I'll have more. Maybe I'll get inspired. I think the— I think, you know, Elon saying he's gonna, you know, that we need to have more kids, I think probably does move the culture. I mean, if Taylor Swift you know, started having, you know, a bunch of kids, like, who knows how much that can move the culture. So like, I think there is something cultural to like making it cool or desirable to have more kids, whether from like a lifestyle perspective, or just like future of humanity perspective, like all the people who are concerned about existential risk, or concerned about technological innovation, or concerned about just like the future at any level. I mean, there's nothing more like fundamental to the future than like—

Yeah, I think I've heard a lot of parents say this, that basically once you have kids, you can't give up on the future because you like have this thing that you care about more than yourself that's like going to go into the future. And I think that's like a, you know, I don't have kids yet, but, um, I think it's like a really interesting like worldview perspective, right? Of like, you know, maybe, you know, if you're just gonna, if you, if you know that you're, you're, this is how much time you have, you know, that's kind of what your horizon is. So like, You know, I don't know. Have you seen that with your friends who have kids? Like, you really feel like they've become more optimistic or they've, they've really, you've really seen that worldview shift in them as they've, as they've become parents?

Yeah. I mean, they, they think much more on a longer time duration and then just, they start to care about sort of, you know, kids just much more, like how their kids are going to be impacted by, by, by certain things. So there is an argument that people who have more kids should have like more say in sort of like voting or something. And I'm, I'm like, reasonably at a high level, I'm like sympathetic to that idea of like, if someone's got 5 kids versus someone who's got no kids, like those people just have a different stake in our, in our society. I don't know how you operationalize that or if that makes sense. But there's, there's something intuitive level.

Yeah, I think that's, I think that's definitely something that people are currently angry about where, you know, you know, everyone who's currently running the US is so out of touch with, you know, what the, what the needs of a young person are. They have no idea how much it, you know, they, they already bought their house. They've had it for 30 years. It's like appreciated or, or, or whatever. Yeah. I don't know. How do you think that like society's gonna cope with, um, an aging population if people don't have kids? Right? Like, what do you, I mean, I feel like there's already been this like huge rejection and like animosity toward Yeah, it's just the fact that like the, the average age of so many of our representatives is like so much higher than the average age.

I'll get to that question in a second. But the counter to the sort of fertility concerns are like, if I talk to my AI or bullish AI friends and they're like, hey, like your concerns around what it means for the economy, if we have less people under a world of, you know, super advanced AI are misplaced because in fact, There's actually way less for people to do in the first place. So, right, you know, the initial concern is, hey, we don't have enough people to make stuff or sell stuff to. But in a world of kind of runaway automation, the concern, the stigma will flip, so to speak. The concern will flip to be like, what do all these people do? We actually need to make work for them. And maybe fewer people, like, alleviates that burden. Of like having a make-work society.

That's a, that's a really interesting take though, right? Because I feel like, you know, it used to be that everyone was farming, right? Like the only thing we could do, like we couldn't even, you know, make enough food, right? And then it wasn't that we said, oh, let's make work, right? It's like we just like invented all these new industries, right? So I don't know. Do you think that basically people are just gonna start twiddling their thumbs and be like, hey, I mean, 'cause think about how much bullshit work people do. I mean, there's like this meme has been going on for so long of like bullshit jobs.

Yeah.

Right? If all that went away, I feel like there's still like, you know what I mean? How much do people self-report that like their day goes the way that they want? Maybe they'll say 5% or 10% or 50%, right? If they could just get that much more done of that much more of like, this is like the highest quality. I don't know. Do you, do you just think that's naive and like—

No, no, no. I think the counter to what I just said is that bullshit jobs are like by definition non-automatable because They, they're bullshit to begin with. Like, they make work. So we're already making work for them. So, so like, we're not going to just replace them with better technology because we could replace them today if we wanted. Like, we're sort of like, oh, okay.

So I think those might be 2 different things, right? There's, I think there's bullshit jobs in the sense that there are fake jobs that don't need to exist. But I guess what I was talking about was bullshit jobs in the sense that so much of your day is bullshit and you would love to automate that and then do more. So yes, I totally agree. Like, we could just cut all the bullshit jobs. Those people, that is like fake work. But I would say, I don't know, I think there's a lot of people who just have a lot of part of their day that they feel like is drudgery that they would love to automate. And I don't know, do you think that's not true?

No, no, I do. I do think that's true. And some of those people will be empowered and enabled and have more fulfilling lives because of that. Some percentage of those people will be fired or not hired, you know, in the future company. For that same role and will need to sort of reinvent themselves. Yeah, I tend to believe that humans will continue to reinvent ourselves to— we will in the good way. We will make work that will add value to people that people will pay for. And maybe over— it just continues to be things that AI doesn't do as well. And part of that is just actually just be a human. People want things made by humans. done by humans. Like, we're not going to, you know, put every service that a human does to AI just because it's AI. We actually want it done by a human, even if it's done, quote unquote, worse, just to some degree. So I think humans will still have things to do. At the same time, it might reduce the pressure of not having as many people. Like, Robin Hanson's been writing a lot about how he thinks like a dark age is inevitable. Because the fertility collapse is inevitable. And I'm not sure in a super advanced AI world that sort of economic collapse is inevitable with fewer people. But those people for whom do exist, I think we will find valuable things for them to do and hopefully fulfilling things to do. So that's why I go back and forth as to how much time or energy should I spend thinking about Like, or prioritize fertility collapse above other problems, or even above AI itself. If I was like solely focused on, on sort of like the future and where things are going, I don't really know how to— like, AI presents a complicating factor for me to think about the like negative effects of fertility collapse. Because if AI wasn't in the picture, then shouldn't like everyone just be focused on fertility collapse? Like, shouldn't we just like— Wouldn't we think, hey, there's a guaranteed dark age coming unless we change something, and then we need to do that now? What else are we focused on? Why are we focused on any other sort of future technology or outcome that's independent of that? Challenging thoughts here.

Yeah, I don't know. I think the thing that— so the one thing that I think is really cool and crazy about it is just that I feel like it's so unpredictable. It just seems like no one has a lot of conviction about a specific future scenario. Almost anything Could happen, right? Like, you know, we're kind of like spitballing here and sort of, you know, it's impossible to say like which, which thing will be true. Um, I think just like from the emerging data, some of the stuff that I think is a little scary that, uh, I hope isn't true is it seems like there's like a really bimodal distribution where like basically the impact of having all of these like superpowers, resources really early in your education is that some people are like super empowered. There's like this, like some percentage of of kids who are like, you know, destroying every like software engineer at Google and like have like these companies that like a company of one person that's like making all this money or whatever. Or just, you know, just bulldozing whatever their creative pursuit is. They like made a movie with like a tiny shoestring budget that's like really impressive. So I think you see a bunch of those, but then you also see, you know, like really, really bad like math and science and reading and just like all of those like core test scores that that, you know, hey, people have like, you know, an LLM tutor, like the best, most personalized tutor ever. Um, Wikipedia, all these different, you know, services growing up that, you know, people, you know, 20 years ago didn't have access to. Why is it that they're doing worse and have less resilience on these, um, tests? So I think that's a little bit scary because you already see that there's like a whole generation that might be like too reliant on technology and like isn't necess— doesn't necessarily have the things that are super important, like grit or persistence or creativity, because they've just never had, they've always had this instant answer that they just, you know, believed was for sure, you know, not as much skepticism as people who had to deal with like all the shittier versions. So I don't know. Do you think that that's true or do you think that's just like hype? I feel like, you know, they always are like, oh, you know, this next generation, there's always this like, you know, catastrophizing of, of the, of a whatever generation is new or whatever's going on.

I think there are elements of it that are true in that certain skills or personality traits either get underdeveloped or don't get developed at all. At the same time, I think others get more strengthened in terms of maybe something like memory gets weaker because we don't have to memorize things anymore, but maybe creativity gets stronger because we can remix things so much better. Sort of our understanding of breadth gets bigger because there's so much, or our ability to intake information, connect it to other information, make sense of it, remix it, amplify it. And so I think something is always lost and something is always gained. It just evolved.

Yeah. Yeah. I feel like the most extreme example of that, of the whole underdeveloped and overdeveloped thing, is basically how Sometimes people celebrate these like super pathological and traumatic childhoods of founders, right? Like, you know, Elon was like really famously, you know, like really bullied. And, you know, a lot of like really successful founders were, and it's like, well, they just got used to like their life being really hard from like birth. So then that, so then starting companies became easy because it wasn't any change, right? It's like, you know, when you're, you know, starting something from scratch, building a new market, building a group. new product. It's like, you know, constant pain and suffering and like just glimmers of, of, um, you know, hope. And basically you have, you know, there's almost this like weird cultishness and, and, um, you know, support of trauma because it basically makes it so that people can create these amazing empires, right? Like sometimes I feel like the, um, I don't know, I feel like sometimes like the unhealthy view that is propagated is like, well, if you were like well-loved and like had a happy, uh, well-adjusted childhood. You don't have enough of a chip on your shoulder. You don't have enough of an insecurity. You don't have enough of a pain tolerance to make anything truly new and exceptional because the only people who want to do that, like, you know, have something to, to prove, um, or just are, are used to, you know, not being satisfied and like, you know, you know what I mean? So I feel like, I don't know, how much truth do you think there is to that? Like, do you feel like you have to be discontent? to, to, to like make something great? Um, do you think you have to, like, are you going to make your child's life, like childhood, like purposefully really hard? Or are you going to make it?

I think there's higher variance there. I think it is probably a commonality among the Jeff Bezos or the Elons or the, the people who are at the top of our society that there was this massive chip on their shoulder since birth. I also think if you compare the people who had this massive chip on their shoulder from birth and the people who were raised in, you know, happy and healthy childhood, secure childhoods without the massive chip. I think there's a higher percentage of like outliers on the chip on the shoulder, but also I think on the average, they're probably doing a lot worse or some level of work. So I think it's just like higher variance in both. And—

What does that mean for your strategy? What is your specific— you take that information and what are you going to do personally? Because I feel like that really says what you really believe.

Yeah, I think I'd probably settle for a happy, healthy kid who has success, but isn't the next Elon, with the risk, of course, that he's like— because if you try to have the next— if you try to have a chip on the shoulder with your kid, that could really backfire. It's probably likely to backfire. Or what do you think?

I don't know. It's really hard. I always feel like it's just like a really intense response to how you were raised. I think I don't know. I was really lucky in the sense that I think I'm one of these weird people who is overloved by their parents, literally just suffocated and loved so much. And I actually am like, dude, I kind of wish I had a little bit of a longer leash. My parents were so obsessive and loving that I wanted to go to just a summer camp for a few weeks, literally nanotechnology, the most nerdiest possible camp. And they were like, oh my God, you have to go to UPenn for 2 weeks or 3 weeks? Like, that's so long. We are going to miss you too much. Like, stay at home. You know what I mean? So I think, um, yeah, I know it's, it's all, it's all very cute, but as a teen, you know, whatever, 12-year-old, you're just like, oh my God, this is like the coolest thing ever. Why are, you know, it's so lame to like stay at home with my parents. Right. I don't know. I just think so much of it is just a response to your own childhood. So, but how much of it do you think is like nature nurture? Is it like, yeah, what would be the percentage that you would—

I'm just guessing 75 nature, 25 nurture. I'm kind of just, I'm just, I just threw a number out. I think it's like slightly more nature than nurture, but I don't have a sophisticated understanding of that.

Oh, okay. Wow. Okay. You're pretty wise. I feel like usually when I just ask the question to people who don't have kids, they'll say it's like, you know, 50/50, you know, nature, nurture. And then—

What do you think it is?

I think it's like closer to, yeah, 75/25, 75 nature, 25 nurture. But, um, basically what I've seen really informally is that if you ask parents, you know, if they have like 1, you know, 2, or, you know, more than that many kids, parents never say 50/50. They're like almost always like something above 70. They're like 80/20 or like 90/10 because they've just seen this little human and they're like, what? This human has like all of these preferences and this human has all of these preferences. And like, I fed them the same and like loved them the same. And they're just like shocked by how different the personalities and the preferences are ingrained. Um, so young. So I think, I don't know, some, uh, people who are parents have said that they find that realization really freeing because they're like, you know, maybe it doesn't matter how they parent them, right? It doesn't matter if they love them a lot or love them a little bit, like, or, you know, they, um, you know, really pressure them to like play piano or, you know, pressure them to be like a physicist or whatever. It's like they're already who they are and, you know, you're kind of just along for the ride. So, um, I don't know. I don't know which, I don't know which one is, is true or what the right, what the right way to be is, but just, that's kind of like the observation that, um, you know, I've been hearing that I, that I think is, um, yeah. Another thing that I think is like a really cool part about being a parent is that like just totally shifts your perspective because your personal experience with like seeing like the human mind come online and like a personality get formed is like, you know, you see that first person with, with someone that you see, you see yourself in that person. You're like, oh, okay. Like that's You know, there's like, there's like someone who I was talking to recently and they, they could tell that their child was like excited about something that they were too. And, um, again, that's like really hard, right? Because nature nurture, were they exposed to it or was it, um, just something that they had a natural, um, inclination or aptitude or whatever for?

Maybe we could wrap with, why don't you just give a little bit more details about how actually the, the test works for parents who are listening in and want to, want to try Orchid, what does that look like?

Yeah, so Orchid is available nationwide. So pretty much every major city, you can get access to Orchid, which is the world's first whole genome sequencing for embryos. So you can get access to 100 times the data and many more monogenic and polygenic diseases. And the way that you get access to it is you can go to our website, orchidhealth.com. You can do some basically meet with our genetic counselor who can talk to you about, here's some of our preferred IVF centers that we've already onboarded that work in a lot of these major cities. And then you can go basically get set up that route at an IVF center that we've already onboarded. And then alternatively, if you're in love with a specific IVF doctor or center, if you just give us about a 2 to 3 week heads up, we can kind of get them onboarded and queued up to work with us as well. So yeah, mechanically, the way that it works is exactly the same in terms of the IVF side. The IVF side is exactly the same process. The difference is just that you get way more information about your embryos in that genetic report at the end.

Perfect. Nora, thanks so much for coming on the podcast and sharing the future that you're bringing with Orchid and letting us be along for the ride.

Yeah, thanks so much for having me. This is amazing. It's so fun to, uh, talk about so many different aspects of parenting and matchmaking and fertility collapse. And, um, yeah, I learned a lot. It's amazing.

Upstream with Erik Torenberg is a show from Turpentine, the podcast network behind Moment of Zen and Cognitive Revolution. If you liked the episode, please leave a review in the Apple Store. Hey everyone, Eric here. At Turpentine, we're building the first media outlet for tech people by tech people. We're the network behind the show you're listening to right now. We have a slate of hit shows across a range of topics and industries, from our AI and investing cluster of podcasts to shows that drive the conversation in tech with the most interesting thinkers, founders, investors, and influencers, like Econ 102 with Noah Smith. We're launching new shows every week, and we're looking for industry-leading sponsors. If you think that might be you and your company, email me at erik@turpentine.co. That's E-R-I-K at turpentine.co, and let's partner together.