Making Polygenic Risk Scoring Marketable and Ethically Acceptable, According to The Washington Post, Silicon Valley Is Out to Produce “Super-Babies”
Even though ASRM/SART finally declared the procedure useless,¹ the genetic testing industry is apparently not satisfied, with utilizing by now preimplantation genetic testing for aneuploidy (PGT-A) in over half of all U.S. in vitro fertilization (IVF) cycles and wants even more genetic embryo testing before embryos are transferred into the uterus. We are now, indeed, witnessing a no longer only subtle marketing launch of an even more controversial testing procedure for human embryos in association with IVF, so-called polygenic risk scoring (PRS, in association with IVF called preimplantation genetic testing for polygenic diseases, PGT-P). So-far for practical as well as ethical reasons mostly rejected by professional genetics as well as fertility societies on both sides of the Atlantic, we only recently covered in The Reproductive Times the unexplained disappearance of formal negative opinions scheduled for official publication about PRS/PGT-P by ASRM/SART as well as ESHRE, and pointed out that these and some other developments suggested attempts by financial interests within the fertility industry at “rehabilitating” PRS/PGT-P in preparation of more aggressive promotion of this new “add-on” to routine IVF. And—quicker than even we expected—our suspicion was confirmed when The Washington Post (WP) published an interesting and very detailed article, claiming that the Silicon Valley start-up scene is planning the large-scale production of so-called “super babies” through the utilization of PRS/PGT-P. Unsurprisingly, we could not resist addressing this WP article here.
So, after quite a long break, The Washington Post (WP) published once again a lengthy article about an in vitro fertilization (IVF) - related subject;² but this time the article is actually worth reading. It was not only informative but, fortunately, much more balanced between information and personal opinion than the last time Yeganeh Torbati, in principle a writer in politics and now covering Turkey and Iran for the WP, for unexplained reasons delved into IVF practice
The last time, things didn’t go too well, and she, therefore, this time wisely partnered with Elizabeth Dwoskin, since 2016 the paper’s Silicon Valley Correspondent, who, of course, knows everything and everybody in Silicon Valley inside out. Almost leaving IVF unmentioned, the article, however, suggests a lack of understanding of IVF by both writers, since IVF, of course, is not only the principal instrument required for the production of “super babies”—but—as its principal goal—has always, first and foremost, the establishment of a pregnancy, in most cases in a woman/couple with infertility.
The article, nevertheless, offered very interesting insights and details on an embryo testing process called polygenic risk scoring (PRS). And it is, indeed, PRS—in the IVF world called preimplantation genetic testing (PGT) for polygenic diseases (PGT-P)—which is the instrument that, through an embryo’s biopsy at blastocyst stage during an IVF cycle, is now alleged to allow the determination of whether an embryo is genetically at increased risk for a so-called polygenic disease—i.e., based on the collaborative effect of multiple genes (polygenic inheritance), is at increased risk for type 2 diabetes, hypertension, or heart disease.
This new test needs to be contrasted with other forms of PGT. Testing for single gene mutation (i.e., a single gene disease, in IVF called PGT-M) indeed started the concept of PGT in the late 1990s and to this day is, indisputably, the best and most accurate PGT test. Testing for chromosomal abnormalities (aneuploidies, in IVF called PGT-A)—also in several variations already offered for over 20 years—is, as already noted above, much more controversial and, as repeatedly mentioned in these pages, in the CHR’s opinion, should no longer be a routine test in IVF.
That Dwoskin knows the Silicon Valley start-up scene very well becomes very quickly obvious. She, with this article, indeed, succeeded in presenting a very interesting picture involving some of the Valley’s biggest names when it comes to fostering—and even more importantly—to financing new and interesting start-up projects.
A little bit of history
The testing of embryos before embryo transfer initially arose in the late 1990s with the recognition that genetic material from an in vitro produced embryo could be obtained right after fertilization and before embryo transfer, thereby allowing genetic diagnoses of preimplantation-stage embryos and the deselection from embryo transfer of embryos genetically judged unworthy of transfer.
Two purposes arose in principle: (i) testing for single gene diseases, PGT-M; and (ii) testing for chromosomal abnormalities (now called PGT-A). While PGT-M has been a solid success from the earliest days of utilization, PGT-A has become increasingly controversial, with the American Society for Reproductive Medicine (ASRM) and Society of Assisted Reproductive Technology (SART) in late 2024, finally issuing a guidance that for the first time clearly noted that PGT-A in over 20 years of clinical use has been unable to demonstrate any cycle outcome utility.¹
Defining the term “super-baby”
So, here is the new Silicon Valley definition of a “super baby.” As already noted earlier, a “super baby” is always conceived through IVF because, as an embryo before implantation, it must undergo genetic testing to make this embryo more “super.” The IVF process, of course, already mandates the production of embryos with presumed best pregnancy and live birth chances.
But that is, of course, not enough to make a “super baby.” Moreover, testing for a single gene disease—if there is a history in the family (as is currently worldwide practice) is also not enough, at least not for Noor Siddiqui, according to the WP, a young entrepreneur and founder of Orchid, an embryo screening start-up, where else but in Silicon Valley. She according to the article claims to have developed a testing ability in her start-up that allows very reliable whole genome amplification from just a handful of the blastocyst-stage embryo’s cells and, therefore, testing for all known single gene diseases known to mankind, even if their prevalence in the population is similar to the chance of winning in the lottery.
Testing with PRS/PGT-P
And if this claim reminds you by any chance of Elizabeth Holmes (currently for a good number of additional years convicted to prison time) we would not be surprised (and if it does not remind you after all who Holmes is, we suggest you Google her) because—as the WP article points out, leading genomic experts have significant doubts about the accuracy of such extensive genomic amplification from only a handful of embryonic cells from the blastocyst’s trophectoderm. And that a report by Siddiqui’s company about the test was only published in the relatively new F&S Reports journal, is also not very reassuring because it likely suggests that more established—and therefore more credible journals—must have rejected the paper before acceptance by F&S Reports.
But this is not all that Siddiqui promises her start-up Orchid can do; she furthermore claimed, according to the WP, that through the above-noted whole genome amplification, the company’s laboratory, moreover, can also accurately predict polygenic risks of preimplantation embryos for basically every polygenic disease—from diabetes to hypertension, cardiovascular disease, cancer, etc. And this is, of course, absolute nonsense, because even adult medicine is still struggling with this concept of risk prediction, and there—validation studies have been going on for years. The number of published validation studies in human embryos, in contrast, is likely exactly zero.
And then there is, of course, one more major problem Siddiqui apparently does not understand: While in polygenic inheritance multiple genes on multiple chromosomes establish risk, for most polygenic diseases, the genomic risk represents only a fraction of the total risk, with most of the remaining risk coming from environmental factors. And how Siddiqui plans to account for future environmental risks of an embryo, starting during 40 weeks of pregnancy and then after birth over an undetermined lifetime, is unclear, and not only to us.
Practically speaking, what all of this means is that Orchid will, for example (rightly or wrongly) conclude that a given embryo may, for example, have a 2.7% chance of developing type 2 diabetes, a 3.1% chance of becoming hypertensive, and a 1.8% chance of having a heart attack. In comparison, her second embryo may have a 1.6% chance of having a heart attack later in life, but a 3.2% chance of diabetes, and a 2.8% chance of developing hypertension and, all of this, of course, assuming these embryos ever implant, become fetuses, and are delivered, all much less likely to happen a pregnancy and a delivery. And can anybody, based on these percentages, really want to make a choice? We don’t think so!
The likely hidden agenda
But we suspect that this cannot really be the reason why PRS/PGT-P is now, suddenly, cautiously, but increasingly aggressively, promoted by obvious commercial interests like the genetic testing industry, start-up country Silicon Valley, but also, of course, as we recently noted, by the clinical IVF industry.
That the average person will be stupid enough to pay substantial additional money (per WP $5,000) for an already atrociously expensive IVF cycle for totally meaningless risk differences between transferrable embryos for diseases (which by the time the embryos become adults, probably in a majority will already have successful treatments) appears unlikely. This can also be assumed considering that over half of all U.S. IVF patients already pay approximately $5,000 in out-of-pocket fees for PGT-A, as, to the best of our knowledge, no insurance plan covers PGT-A.
The idea behind mainstreaming PRS/PGT-P—we, therefore, believe—is a different one (even though strenuously denied by Siddiqui). Testing for blue eyes was probably the first alleged PRS/PGT-P offering publicly made in the U.S., even though it was already then abundantly clear how inaccurate these predictions were.³ But to spend money for even minor potential improvements in offspring may be a more attractive proposition than chasing the prevention of rare and potentially curable disease. Akin to the PGT-A experience over more than 20 years, this notion is further supported by the fact that random events occur often enough to allow even some of the most ridiculous claims to find a receptive audience (i.e., PGT-A improves pregnancy and live birth rates, etc.) Improving an offspring’s height, weight, getting a certain hair color, eye color, and—even more so—specific talents, of course, including intelligence. In other words, show me the embryo that closest mimics Albert Einstein’s polygenic inheritance pattern, or how about what leads to Michael Jordan’s basketball skills, etc.
It is this kind of PRS/PGT-P that Silicon Valley really believes to achieve “super babies” and, even more importantly, believes to represent a potentially huge additional testing market.
So, where does all of this lead to?
Exaggerating the novelty of Siddiqui’s Orchid start-up, the WP article presented PRS/PGT-M almost as a seemingly brand-new idea, when several companies offering PRS/PGT-P have been around already for a good number of years. The CHR’s Norbert Gleicher, MD, in collaboration with several colleagues, moreover, already in March of 2022, penned an article in the prestigious Nature Medicine journal warning about the premature introduction of PRS/PGT-P to the marketplace in association with IVF.⁴
As the WP article also noted, the concerns expressed by Gleicher et al. in their article are still valid. And while serial entrepreneurs and investors in Silicon Valley are now apparently convinced that—starting in the very near future—all babies—at least in Silicon Valley—will be “super babies,” exclusively produced through IVF plus PGT-M, PGT-A, and PGT-P, with sex relegated to a function of entertainment, prominent genetics experts have seriously questioned not only the accuracy of currently available testing systems but also the practicability of reaching, in the foreseeable future, clinically worthwhile predictive values. And even assuming that genomic associations are significantly further improved, how can one model future environmental exposures?
Interestingly, Martin Varsavsky, a serial entrepreneur, including in the infertility field, already in 2016 predicted sex-less reproduction through IVF and—in those days—only with PGT-M and PGT-A.⁵ We would be surprised if he, since then, has not added PRS/PGT-P to the offerings at the IVF clinics in which he has invested
And then there are, of course, also still all the major ethical concerns about PRS/PGT-A, from strengthening inequity in society, to the concept of eugenics, we especially recently had the opportunity to repeatedly address in the CHR’s VOICE, and in The Reproductive Times. Eugenics is, of course, a concept the CHR strongly opposes.
Finally, we cannot remain quiet when we see people, whether Silicon Valley mavens or journalists, as in the case of the WP article, ignoring the most basic purpose of IVF, which still is (or at least should be) to provide women with the best possible chances of conception. Yet, as a medical specialty, we have been increasingly moving away from this main purpose of IVF by constantly finding additional reasons to not use—or even discard—embryos unnecessarily and thereby, indisputably reducing our patient’s overall (i.e., cumulative) pregnancy chance in their IVF cycles, while, concomitantly, steadily increasing the costs of IVF and extending the time to pregnancy.
Truly shameful!
References
Practice Committees of the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology. The use of preimplantation genetic testing for aneuploidy: a committee opinion. Fertil Steril. 2024;122(3):421-434. doi:10.1016/j.fertnstert.2024.04.018
Dwoskin E, Torbati Y. Tech companies look to create "super babies." The Washington Post. Updated July 17, 2025. Accessed August 1, 2025. https://www.washingtonpost.com/politics/2025/07/17/tech-brief-superbabies/
ABC News. Designer babies: Creating the perfect child. ABC News. March 3, 2009. Accessed August 1, 2025. https://abcnews.go.com/Health/story?id=6998135&page=1
Gleicher N, Albertini DF, Patrizio P, Orvieto R, Adashi EY. The uncertain science of preimplantation and prenatal genetic testing. Nat Med. 2022;28(3):442-444. doi:10.1038/s41591-022-01712-7
Helft M. Building a better baby. Forbes. November 8, 2016:84-91.