The Exchanges

Q That's fun. So in terms of the team, um, Kian, how big is the team and what is the makeup of that?

A Yeah, we're a pretty small team, actually. We're only 14 people full-time. Um, we have, I mean, I think I like to joke that half has a PhD, half is under 25, which honestly, it's approximately true. Um, so, uh, we have a chief scientific officer who used to run one of the largest, um, DTC academic projects. We're providing kind of innovative genetic analyses to customers. Um, Lasse Folkerson. Um, we have, uh, you know, People who used to work at the National Human Genome Research Institute and do their communications for Warner runs our communications. We have people who used to actually do comms at Ancestry, right, Ancestry Health, the former technical director of Genomics at LabCorp, many, many others, but the, we have a very deep bench of kind of technical talent across, you know, science, communications, um, you know, and beyond really. I mean, because if you're on our technical bench, it's not just about the bioinformatics, the statistical genetics, Also even the communications. It's just about, you know, the engineering, the full stock development, the systems architecture, right? So in terms of kind of complexity, if you want complexity, you should come to Nucleus.

AI assessment note: “We're only 14 people full-time. Um, we have, I mean, I think”

Q That's fun. So in terms of the team, um, Kian, how big is the team and what is the makeup of that?

A Yeah, we're a pretty small team, actually. We're only 14 people full-time. Um, we have, I mean, I think I like to joke that half has a PhD, half is under 25, which honestly, it's approximately true. Um, so, uh, we have a chief scientific officer who used to run one of the largest, um, DTC academic projects. We're providing kind of innovative genetic analyses to customers. Um, Lasse Folkerson. Um, we have, uh, you know, People who used to work at the National Human Genome Research Institute and do their communications for Warner runs our communications. We have people who used to actually do comms at Ancestry, right, Ancestry Health, the former technical director of Genomics at LabCorp, many, many others, but the, we have a very deep bench of kind of technical talent across, you know, science, communications, um, you know, and beyond really. I mean, because if you're on our technical bench, it's not just about the bioinformatics, the statistical genetics, Also even the communications. It's just about, you know, the engineering, the full stock development, the systems architecture, right? So in terms of kind of complexity, if you want complexity, you should come to Nucleus.

AI assessment note: “We're only 14 people full-time. Um, we have, I mean, I think I like”

Q Well, there's a lot to break down there and so much to get into, especially the couple optimizing for IQ. Um, first I want to get into the genetic optimization software for embryos. What does this actually mean?

A What this means is, you know, parents for the first time ever can give their children the best start in life. So often, you know, the first thing parents think about when they're having healthy children is how do I not pass down like a rare disease, right? Something like maybe someone's a carrier for cystic fibrosis or something like Huntington's, for example, and they might think, okay, how do I not pass this down to the child? Then they think about maybe other diseases like common diseases, like breast cancer, like heart disease, These are conditions that, generally speaking, are just simply not tested in the clinic today. So let's say you're a couple doing IVF. The first thing that's very well accepted in the IVF context is making sure your child doesn't have any chromosomal abnormalities, like Down syndrome, for example. Ok, so that's the first thing. Then they might test for rare hereditary diseases, as mentioned, like cystic fibrosis. But then that's it. They don't test for common diseases like cancers or heart disease or schizophrenia. They don't run any more sophisticated modeling of genetic prediction on things like IQ or height, for example. And so what really we're doing is we're completely empowering the patient with the full genetic profile of their embryos so they can, they can genetically optimize their children.

AI assessment note: “empowering the patient with the full genetic profile of their embryos”

Q to take a step back and actually understand how important this moment is in the grand scheme of fertility. There are like significant shifts in the US for fertility. Um, it seems commonplace now that couples are freezing eggs, that they're using IVF. Um, and even broader than that, there's declining birth rates worldwide. Could you put some data behind all of this? What is the current state of fertility?

A Well, you make a great point. First off, birth rates are declining. Um, IVF is becoming much more commonplace. I mean, I think the statistic is that one in 50 babies today are born via IVF. That would be crazy to say a couple decades ago. I mean, at some point, IVF babies were, you know, test tube babies, right? Now it's just how people have children. And you can imagine as it becomes easier and easier, maybe you take stem cells and make an egg or sperm, as it becomes easier and easier and less invasive to make an embryo, You can imagine that IVF is going to become more and more ubiquitous. And it's interesting because, you know, I always talk about the decrease in cost of whole genome sequencing. What used to be a billion dollars is now a couple hundred dollars. That obviously DNA being the generational health tool that it is, doesn't just impact adults and longevity, but also impacts fertility. And so you're going to see the rapid decrease in cost of IVF combined with the rapid decrease in cost of sequencing A genome. These things are going to converge together to enable this just, this massive, massive new generation of parents having genetically optimized children.

AI assessment note: “I think the statistic is that one in 50 babies today are born via IVF.”

Q What are the specific categories of traits and conditions that you're analyzing? How accurate are these predictions?

A Yeah, so the different categories ranges from cancers, um, to, like, you know, heart conditions, to, like, mental health conditions, to, like, um, something like physical characteristics, like height, or eye color, or, like, hair color. And regarding the predictability of the models, there's a large range, depending on how genetic something is. For example, people might intuitively guess that something like height, right? Height, you would probably guess, you'd probably guess that's pretty genetic, right? You look at mom and dad, you're like, okay, this thing is like pretty genetic, which it is, right? And so that model tends to be a very good, strong model. Let's say something like depression. Depression's dramatically more environmentally driven, right, than height. And with that, you would expect that model to be dramatically worse. And so DNA isn't deterministic, and that's actually not a bug, that's a feature, right? Obviously DNA, if it could predict everything, that there would be no free will, right? But it can't. And so one of the things that we're really careful in doing is we actually tell patients when they're using our services which models are better, which models are worse, and the way we present results to patients always takes this into account in that if a model has lower genetic predictability, you would basically see the deviation or the prediction of the mo…

AI assessment note: “the different categories ranges from cancers, um, to, like, you know, heart conditions”

Q So why, why is that controversial? I know that Nucleus itself was kind of, ah, the crosshairs of a couple of different articles that were put out on the web from researchers from MIT and from Harvard, but could you just break down, like, why is that controversial at all?

A That's a good question. I think there's a lot of historical baggage first and foremost. Um, and then moreover, I think that in medicine today, people tend to think that, um, information without any very clear clinical guidelines should not be given to a patient. And with that perspective is it's a very paternalistic perspective and then kind of paternalism can kind of become gatekeeping. Um, so I think they view it as dangerous as something that given to someone could really dramatically affect them negatively, not positively. So for example, if you give someone a schizophrenia, genetic risk, they won't understand it. You know, it's, it's, it's something that will, you know, kind of mess with the psychology, et cetera. Um, we, I think, believe that one is there should be no broker of genetic insights. No one should decide for you, except for you, What access, what information access you get? Uh, moreover, we think that we can build better and better communications to explain people the kind of nuances of these scores. If you look at our reports, for example, I'm sure they don't look like any other genetic reports you've seen, right? I think they're quite tasteful. They're extremely thoughtful. Um, they explain everything to the customer. You can get as deep as you want in the, in the results. Um, and we also employ, I think scientifically sound, uh, different, uh, kind of, Uh, …

AI assessment note: “people tend to think that, um, information without any very clear clinical guidelines should not”

Q Could you share more about this? What was the live about?

A Yeah, absolutely. The live was an amazing space for our lead investors, our scientific advisory board, um, and kind of customers, et cetera, to all come together and talk about, uh, the public launch of Nucleus IQ. Um, I think we heard some amazing anecdotes, not only from sort of the Silicon Valley tech investors, but also from more classical scientists, um, traditional geneticists, Both super excited about the release of Nucleus IQ. And I think the reason for this, why, you know, across expertise, there's such kind of unanimous excitement is because everyone is excited about Nucleus's mission, which is integrating in genetic insights into everyday life. We mean that from the individual health perspective, which is about looking at your DNA and predicting your future health. We mean that from the, uh, generational health perspective. Making sure you can use your DNA to have healthy children. And then of course, the one, um, the only thing that we're talking about today, which was personal discovery, using your DNA to learn amazing new things about yourself that you didn't know, such as your IQ or longevity. Um, and so I was, you know, doing a demo of the Nucleus IQ report. It was a little buggy though. Um, so maybe I'll do it again now, Molly. What do you think?

AI assessment note: “to all come together and talk about, uh, the public launch of Nucleus IQ”

Q How far can you take picking out traits though? Like, can you make an Elon Musk baby or a Kylie Jenner baby?

A No, you can't. Um, you can, so one of the most important things to understand is that when you are doing embryo selection, right? The possible memories you have is based off your partner. Okay. So the most important decision actually is who's your partner, right? Like if you want like a really smart baby, you should probably marry someone that's really smart. Right. If you want a really tall baby, you should probably marry someone that's really tall because the embryo selection will always be a relative optimization, right? IQ can explain a couple IQ points, right? Um, height, you can, you know, explain a couple inches, but principally if you, the most important kind of the ingredients for your embryos comes from mom and dad, right? So that's like by far the most important decision. Embryo selection is always a relative optimization, but even though it's a relative optimization, it can still be a highly useful relative optimization, right? You can still dramatically reduce the baby's risk, for example, for something like Alzheimer's, Which is then strongly associated with longevity or breast cancer or coronary artery disease, which are the top killers in the United States today. And so all this to be said is that, you know, you can't make Elon, which I don't even know if you want to make Elon. You can't make Elon, but you can give your baby the best star in life. It's an import…

AI assessment note: “No, you can't... the embryo selection will always be a relative optimization”

Q Could you share more about this? What was the live about?

A Yeah, absolutely. The live was an amazing space for our lead investors, our scientific advisory board, um, and kind of customers, et cetera, to all come together and talk about, uh, the public launch of Nucleus IQ. Um, I think we heard some amazing anecdotes, not only from sort of the Silicon Valley tech investors, but also from more classical scientists, um, traditional geneticists, Both super excited about the release of Nucleus IQ. And I think the reason for this, why, you know, across expertise, there's such kind of unanimous excitement is because everyone is excited about Nucleus's mission, which is integrating in genetic insights into everyday life. We mean that from the individual health perspective, which is about looking at your DNA and predicting your future health. We mean that from the, uh, generational health perspective. Making sure you can use your DNA to have healthy children. And then of course, the one, um, the only thing that we're talking about today, which was personal discovery, using your DNA to learn amazing new things about yourself that you didn't know, such as your IQ or longevity. Um, and so I was, you know, doing a demo of the Nucleus IQ report. It was a little buggy though. Um, so maybe I'll do it again now, Molly. What do you think?

AI assessment note: “talk about, uh, the public launch of Nucleus IQ”

Q down and understand how You're measuring IQ with nucleus and then how, you know, you can take any sort of consumer IQ test online. Like, I'm not gonna lie. Like, I'm kind of obsessed with that too. I think it's really interesting. I have this like brain training app and I track that and I think it's cool, but like, what is the difference between that and then also intelligence?

A Yeah. So, you know, as a genetics company, what we do is we show people their genetic contribution to intelligence. Um, and you know, you're right. We do use the word intelligence and IQ a little bit interchangeably. It's actually a thing in the literature. People tend to swap these things. Technically the definition of IQ that we sort of use is sort of, uh, kind of a lowercase g or general intelligence. That's sort of what the researchers are trying to gauge in the paper that we use to build the models. Um, the thing is though, all the different, um, kind of measurements of intelligence, they tend to correlate, right? Um, so you can kind of somewhat interchangeably use these terms, even though they're not exactly the same thing. Um, regarding nucleus specifically, we want to show people how their genetics contributes to, um, their intelligence. We are not necessarily at this point. You can't. From genetics predicts someone's IQ. And actually what a lot of people don't realize is you will never be able to. And the reason for that is because 50% of intelligence is environmental. The other 50% is genetic. Um, so even if you built a perfect genetic model, and we actually show this in the reports, even if you built a perfect genetic model, you would still have error bars in the prediction of someone's actual IQ, which I think is pretty fascinating. Um, so That's kind of how the, th…

AI assessment note: “we show people their genetic contribution to intelligence”

Q I mean, it still is very quiet. I mean, not to pull like too far of a comparison, but most people know about genetically modified agriculture or like dog breeding and that sort of kind of selection. But how do you think about this in terms of quote unquote, like designer babies and the controversy that surrounds it?

A I think that, you know, embryonic selection today, if you look at what's actually going on is you have a couple of viable embryos and basically parents will pick the embryos completely randomly. Um, and I find that, um, like kind of crazy. Like it's the most, arguably one of the most important decisions of your entire life. What a baby you're going to implant your future child and you pick randomly. And, and so I think, um, What we're really doing is giving people more information to then be able to say, okay, I actually prefer this embryo over this one, maybe because it has dramatically less Alzheimer's risk. That's what this is really about. It's about just people having healthy children and, you know, picking the best baby in their mind, whatever that means to them, of the options they had. I do think that, you know, over time, this is really powerful technology. I think genetic testing technology and analysis technology, genome technology, if you will, It's going to be as powerful as artificial intelligence. Artificial intelligence is ultimately a tool, and it's a tool that's going to, I think, be most consequential in the field of human genomics, right? Because DNA is life. It's literally, you know, it's, it explains everything. It's how we all begin. I think part of our job is to be really responsible stewards of this power of technology, and the best way in our mind of d…

AI assessment note: “That's what this is really about. It's about just people having healthy children”

Q And so what did that entail? Like, what, what was the early innings? Like, what were you working on?

A It was a lot of very deep work in kind of statistical genetics and computational genomics to figure out how do you actually build such a piece of software? What are the actual underlying algorithms that you can use to analyze DNA? Um, I think there's a, there's kind of different ways of thinking about this. Like, yeah, there's a, there's a concept in, you know, CS about like breadth first search, um, versus depth first search. And I feel like you have to go kind of very, very deep and then kind of build yourself all the way back up. So like you can read a newspaper And then pretend like, oh, I understand the space. I read this newspaper. Maybe you get a little bit more technical, a little bit more technical, maybe even glance through a, a research paper, right? But you don't really get it. I think what you have to do inside is you have to go extremely deep, so deep that you have almost what I think is this, this intellectual foundation. This, uh, you, you end up at an intellectual frontier. Then once you're at the intellectual frontier, you realize that how, how much space there is to build and that you can actually productize what you know, um, and Execute on what I described, which is building the gap between what exists and what, what could exist. So it was a lot of independent research. I think I filled in like 18 different subject notebooks of material. Um, I still have th…

AI assessment note: “It was a lot of very deep work in kind of statistical genetics and computational genomics”

Q Why do you think that parents still feel like having children is hitting a lottery ticket?

A Well, look, I think people are having children much later on, right? And IVF is a hard process. I mean, I think IVF takes a big toll on the woman's body and it's expensive. Um, it can be demoralizing, right? If you have a miscarriage or the, or the like. And so it's totally understandable that by the time you have a couple of viable embryos, you would want to get any amount of information that you can possibly get to basically pick your baby. Um, I think that, you know, IVF is something that it's going to eventually get less invasive, but today it is still pretty invasive and it's still pretty expensive. And so I really think a technology like nucleus embryo will help couples have even more confidence when they're making that choice that, you know, they're giving their child the best possible start in life.

AI assessment note: “by the time you have a couple of viable embryos, you would want to get”

Q I guess it's a push on that though. Like, are you seeing more adoption within consumers or has the COVID kind of awareness started to wane off?

A Yeah, I think so. I mean, I, I think if you look around, you know, Huberman, Brian Johnson, Peter Atiyah, I think almost a good, uh, kind of heuristic for culture is like, who are its influencers? And there are health influencers. There are, there are people whose job it is to basically say, here's what you can do to prevent disease. Here's what you can do to live forever. Um, we're happy to be a sponsor of Brian Johnson's Don't Die conference in September. And That conference is an amazing opportunity for all the people who kind of follow the blueprint diet to, you know, we're the official genetic testing partner to actually get their DNA sequenced. Um, and so I think there's definitely momentum, um, you know, across, I think the entire country. I also think to some extent it probably skews a little bit younger, but I think it, it, it kind of transcends generations to some extent. People are more curious about their health. People want to Live longer. People want to prevent disease. People want to measure what was previously unmeasurable, and Nucleus, you know, lets you do that.

AI assessment note: “I think there's definitely momentum, um, you know, across, I think the entire country.”

Q Do you have any sort of sense how many tests have been sold like globally over the last couple of years? Like, do you have any sort of idea how many people are buying them?

A Um, so 20 to me is a database around fifteen million people. Ancestry, I think it's around thirty million, so let's just say forty-five million. Um, let's just say one in six people, I think, in the United States approximately have probably done consumer genetic tests. Of course, that doesn't include, that doesn't include clinical genetic tests, right? Um, so I would think that's a good ballpark number, but of course, the United States is three hundred million people. And the other kind of side of that is, sure, that's a lot of people, but why did hundreds of millions of people not get Their genetic testing done, right? This is information that could save your life. Um, um, if you, it's, there was a great study that showed millions, millions of people have a DNA difference right now that dramatically increases the risk for breast cancer, colorectal cancer, two diseases that are preventable, that there's very clear evidence-based recommendations that could prevent these conditions and greater than 90% don't know it. That's the problem when genetics isn't integrated in clinical practice, life-saving insights. Right? That nucleus can give you. Insights that you can get from a swab. It's not even like it's, you know, there's a blood test that doesn't need anything. It's a swab. You can swab your cheek and get a result that could save your life. Yet millions of people don't know. I …

AI assessment note: “20 to me is a database around fifteen million people. Ancestry, I think it's around thirty million”

Q still like a very early category. Like this was something seen as sci-fi and many of your announcements always seem like sci-fi, but it is reality, um, now and, and something that people haven't actually considered. And so maybe the education on it might be limited, but I'm just curious, how does Nucleus fit into this broader fertility crisis and how are you educating people that these tools do exist?

A One of the core pillars we have is, is customer obsession. So I think what makes us different than a lot of other IVF genetic testing companies is there's a lot of technical improvements, but even beyond that, we're for you. We build software for you. Doctors and physicians, unfortunately, they have the key today on people's embryos. If you go and talk to fertility clinics, um, if you go talk to doctors, Right now, the doctor is the one that basically gatekeeps and controls what information couples can access about their own children. And so going back and kind of paralyzing this to the adult testing world, which, you know, today Nucleus is known for, in the same way, often doctors will gatekeep genetic tests for adults, it's even to more extreme extent in the context of embryos, because other people will make value judgments for couples on what information they should and shouldn't get. We completely reject that. We believe that every piece of information from cancer to IQ to schizophrenia belongs very thoughtfully in the hands of the patient, and the patient is the one, not the doctor, that the patient is the one that should pick their embryo.

AI assessment note: “One of the core pillars we have is, is customer obsession.”

Q As we wrap up, I like to draw out two separate segments. So one, drawing off of this, what are your outlooks for the year? Like what, what comes next for Nucleus? You guys are dropping news like every month, it seems like.

A We're, we're, we're, I'm very proud of the team. We're, we're shipping a lot. The team is fantastic. We're on a tear, honestly. Uh, We have a lot of exciting stuff coming up. I mean, I do want to say that when you think about Nucleus, I think people are starting to see us for what we are, which is, it's, it's well beyond a genetics company. Um, generational health, this concept of building tools, not just for adults, but also children, and then the kind of, yeah, like literal, you know, inextricability of that, it doesn't exist. There is no precedent. There is no one that has really tackled this, this, this, Uh, generational health component. And when you think about the next 10 years, you know, as I alluded to earlier, sequencing technology is kind of cheaper, analysis is kind of cheaper, understand the genome is going to dramatically increase, and genome editing is going to become much cheaper. And so you see all these technologies form together into something that I really believe is a trillion dollar business. Um, but really, for me, it's about two things. It's about the sincerity of my love, For, for this, just, I love it. I love this discipline. I love, I love kind of, uh, you know, the bits and atoms in that world, but also about the customer. I always think about my cousin, you know, who she went to sleep one day and she died. And I think, well, a swab could have saved …

AI assessment note: “We have a lot of exciting stuff coming up. I mean, I do want to say”