Has fertility marketing lost its mind?

Hello everyone, happy Friday!

A few weeks back, I came out of an NYC subway station and saw an ad that made me do a complete double take.

What the f*ck? Has fertility marketing lost its mind? I snapped this picture, thinking I’d want a record of this madness because surely it was a one off.

Nope. I later get on the subway at Broadway Lafayette. And the entire station is covered. Completely inescapable.

“Height is 80% genetic”, “Have your best baby”, “pickyourbaby.com”. The messaging was everywhere, like some weird dystopian nightmare in which we design perfect babies to live perfect lives. So of course, as a former ad agency exec, I had to wonder, “who created and actually approved this bullshit?”.

The answer leads us to… Nucleus IVF. A genetic selection startup that raised $30M to pursue a mission to “end preventable disease” (in the founder’s words). The mission makes sense; the CEO’s cousin died at age 16 of a rare genetic condition. That’s real, and painful, and awful, and I am 100% in favor of advances in technology that allow us to eliminate genetic conditions and preventable diseases that shorten life and cause debilitating health issues.

But that’s not what Nucleus IVF has built. Instead, they’ve built a test to screen embryos, selling parents the ability to “Pick your embryo based on predicted height, IQ, and more” for a price “starting at $9,999”. That’s on top of the $30k or so you’re already spending on IVF. An MIT Technology Review described the company as selling “the sizzle of genetic trait discrimination.” And that’s exactly what it is: genetic selection as a lifestyle choice for the privileged, monetising the desire to select for traits that have nothing to do with genetic disease and everything to do with genetic preference. Sidebar: Nucleus’s CEO did a Reddit AMA last year, presumably with noble intentions, and got appropriately roasted by the brilliant and cynical Reddit community.

So far, most leading IVF clinics have refused to offer embryo screening tests that predict traits like height and IQ. But here’s what’s scary: by running sexy and fear-led ad campaigns targeting consumers directly, these companies are creating patient demand. Patients will start asking their fertility doctors for these tests. And when their doctor says no, the patient finds a different doctor at a different clinic who will say yes. And because almost all fertility clinics these days are owned by Private Equity and incentivised to drive revenue and patient volume, well… we already know where this is going.

As I dug deeper into genetic selection and AI in reproductive medicine, one line from Dr. Barry Behr (director of Stanford’s IVF lab) in a Fortune piece really stuck with me: “There was a time when it wasn’t appropriate to show your knees, and now you can wear a thong at the beach. The line moves with time.”

Sure, morality evolves. But here’s what terrifies me about the line moving on genetic selection: when we’re talking about thongs on a beach, we can all (mostly) make and access that choice. But genetic screening and embryo selection? That’s expensive, typically not covered by insurance, and only available to those who can afford it. So that ‘moving line’ moves exclusively for the privileged, while everyone else stays stuck with random genetic chance. I’ll call it out: we are shamelessly flirting with positive eugenics. And because it’s done at arm’s length in a lab, supposedly in service of “health,” we’ve found a way to feel so comfortable about it as a society that we launch entire ad campaigns telling us to “Have your best baby”.

The technology to eliminate rare genetic disease is incredible and should absolutely be celebrated and used. That’s not what I’m questioning. What I’m questioning is the access gap, which is about to get so much wider. Most of us dealing with fertility challenges are fighting our absolute hardest just to have one baby, period.

In infertility, accessibility and affordability mesh with ethics and privilege in a way that forces us to sit with uncomfortable ideas. This technology has massive potential for good, and for harm. We need to pay attention to where this is heading and who gets left behind when the line moves.

And if you’re trying to conceive and worrying that you’re doing your future child a disservice if you don’t pony up for the genetic test to ensure they’re mathematically gifted and appropriately tall, take a breath and remember: IQ and height don’t equal health or happiness. Whatever baby you’re trying for, whatever height they end up being, they’ll be loved by you. And that matters infinitely more than any algorithm could ever predict.

Take care of yourself this weekend.

Warmly,

Tess,

Co-founder & CEO