If you could design your ideal baby, what would you choose? A lover of naps who sleeps through the night? A mind for math and an affinity for the viola? For the founders of fertility tech startup Herasight, this is not a hypothetical.
“It’s annoying to be super tall,” he said. “Nothing is made for you.”
Chief science officer Tobias Wolfram has already banked frozen embryos with his partner in preparation for their future family. His great-grandparents lived past 100 with no cancer or serious health problems, suggesting a family tendency toward healthy aging. But there’s depression on his side of the family.
“I’d really like to make sure that’s not passed down,” he said. Wolfram has waited five years for Herasight’s technology to reach its current state, so that he can screen embryos for mental health indicators.
Jonathan Anomaly, a communications executive with Herasight, is approaching 50 and planning a family with his partner, 37. His grandmother was a genius, said Anomaly, but she suffered from five different autoimmune disorders that kept her homebound. He plans to screen embryos for autoimmune diseases, and like Christensen, Anomaly said he’ll screen for height. But he wants potential sons to be slightly taller than his 5 feet 9 inches.
This is the new era of family planning emerging across the Bay Area, a place known for its concentration of extreme wealth, high risk tolerance, affinity for new technology, and early-adopter mentality. Rather than having babies the Where Did I Come From? way, prospective parents are blazing an unprecedented approach to family planning. Gone are the wealthy parents who pay women for their eggs because they have desirable traits or who seek out sperm donors based on Ivy League degrees and athletic prowess. This is reproduction reimagined through the lens of algorithms and data science down to the genetic blueprint that makes up a human being.
This new method means opting for IVF from the start even if infertility isn’t an issue to create embryos. From there, prospective parents are investing thousands in different types of next-level embryo screening that can essentially spin up versions of your future children’s health prospects by showing their risk of inherited diseases, childhood cancers, schizophrenia, autism, and Types 1 and 2 diabetes. Other traits like height, body mass index, musical ability, and higher IQ points are also among the offerings at certain firms. And with billionaires backing fertility tech startups and funding new research related to conception and embryo selection, the boundaries between proven science, emerging possibilities, and aspirational hype become increasingly complex to parse.
“A parent would do anything—give a kidney, give a limb, or whatever you could give to a child to avert suffering,” said Behr. “So don’t tell me how anyone could even question doing something to your embryo that we do for other reasons routinely.”
Yet the rapid pace of innovation and investment has created a regulatory and ethical vacuum, experts have observed. “Technology will always outpace the law,” said Rich Vaughn, a prominent fertility lawyer who has seen the field evolve during the past two decades. “Technologies develop first; law and regulations make things legally safer for everyone, but they trail behind.”
“I believe that gene correction technology is much more effective in achieving those goals than embryo screening,” said Tie, cofounder of Manhattan Genomics. She plans to begin testing on nonhuman primates early next year before moving to human embryos, pending regulatory approval.
Tie believes many couples, especially those with relatively older women, wind up with too few embryos to choose from after they go through the process of stimulating their follicles and retrieving eggs. “Let’s say I’m a woman in my mid-thirties,” said Tie. “I’m lucky if I’ll get 10 eggs, and from that I’ll maybe get two embryos. Then a company will tell me one embryo is better than the other.” Despite public controversy over embryo editing, which alters genes that would be passed down to new generations and involves irreversible decision-making, Tie said she has received a lot of support from researchers, scientists, and IVF doctors.
Hank Greely, a Stanford law professor who specializes in issues surrounding biomedical technologies and authored The End of Sex, a 2016 book that predicted humans will eventually reproduce mainly through IVF, told Fortune screening for cosmetic traits like hair, eye, and skin color or nose shape isn’t far off.
People in Silicon Valley, where Greely lives, are most interested in influencing their offspring’s intelligence, personality, musical and sports ability, and proficiency in math. Right now those are areas scientists “know almost nothing about,” he said.
But the technology is moving at a swift pace, and some experts think the line between acceptable and not will evolve as well.
“There was a time when it wasn’t appropriate to show your knees, and now you can wear a thong at the beach,” said Behr. “The line moves with time.”
Reproductive tech startup CEO Noor Siddiqui has a personal inspiration behind founding polygenic screening firm Orchid Health. Her mother suffers from a rare genetic eye condition called retinitis pigmentosa, which led to progressive vision loss and her mother’s eventual blindness. Siddiqui, also a Thiel Fellow, said she was motivated to pursue embryo screening after watching her mother’s condition progress. Siddiqui also plans to have four children, and has screened her own embryos using Orchid’s technology.
The firm occupies the middle ground of the IVF tech market—pushing the boundaries of science, but mainly to prevent disease.
For years now, prospective parents who use IVF to have babies have been able to opt for preimplantation genetic testing to make sure the embryo has the correct number of chromosomes. In addition to chromosomal abnormalities like trisomy 21—an extra copy of chromosome 21 that causes Down syndrome—tests also scan for life-altering diseases stemming from single-gene mutations like sickle cell anemia or cystic fibrosis.
Orchid’s approach involves whole genome sequencing, and expands on traditional screening by sequencing nearly all of an embryo’s genome. Siddiqui said Orchid scans for more than 1,000 genetic diseases as one option for clients, while another option scans for 3,000 single-gene diseases, covering inherited and spontaneous changes in the embryo. Traditional tests scan for chromosome numbers and single-gene disease. She often compares it to publishing a book that a writer would want to be fully accurate.
“We want the maximum amount of information to be provided to parents to mitigate the maximum amount of risk when it comes to genetics,” said Siddiqui.
“Everyone has a unique family history, so we don’t have one type of customer,” Christensen told Fortune. Sometimes a prospective parent will come to the firm, excited about screening embryos for IQ, and then they’ll discover a BRCA gene mutation, which can increase the risk of breast and ovarian cancers. Then that becomes the top priority in screening embryos, said Christensen. Anomaly said every embryo-screening choice represents a tradeoff. “Creating the perfect baby—that doesn’t exist,” he added.
Kyle Farh, a scientist with DNA sequencing and genetic analysis company Illumina’s artificial intelligence lab, said a huge gap in data interpretation remains at the moment because AI models simply need more information. About 1 million people globally have sequenced their genomes, and realistically about 1 billion people need to sequence their genomes for models to function more meaningfully.
“It’s a chicken and egg problem,” said Farh. “We can predict [traits], and we can show that there’s some significant correlation between our predictions and what happens in real life, but the correlation is still very poor.”
“I mean, we spent all this money, we did this whole thing and got through all this,” said George. The test showed Astra’s hearing was normal, and the new parents were relieved and are planning for another child soon; they still have screened embryos, George said.
But the use cases that scientists and ethicists fret about aren’t quite here—yet. “Even the most optimistic folks—and I think scientists and most geneticists are way too optimistic—think they can account for, oh, three or four IQ points,” said End of Sex author Greely. “Plus, we know plenty of ways to improve IQ test results with things like good childhood nutrition, childhood vaccinations so kids don’t get sick, and parents who read to their kids.” Brains are incredibly complicated, he said, and may ultimately prove too complicated to screen for intelligence and qualities like extroversion.
“It makes great headlines, it makes great clickbait, it makes great dystopian science fiction,” said Greely. “But the designer baby idea? At least when you’re talking about behavioral traits, it’s not very plausible—at least for decades.”
But given the intensity and expectations of the tech-oriented set interested in this brave new world, NYU bioethicist Arthur Caplan notes there’s a danger that some parents might view their children as products and potentially even “commercial failures.” He questions how positive this will be for kids. “When you start saying, ‘I tested you, and I have a certain outcome that I expect,’ you’re taking away the kids’ future,” said Caplan. “You’re making them less free because you have expectations, and they better turn out that way.”
Victoria Fritz and her husband, who used Herasight to screen embryos to try to prevent passing along her Type 1 diabetes, hope to do an embryo transfer in January, and are realistic about the prospect.
“I feel like, regardless of what embryo we choose, we will hopefully have a happy, healthy child and be a happy family regardless,” said Fritz. The screening provides peace of mind, she noted, but “it doesn’t guarantee that your child is going to have a perfect, healthy life.”
