You did the retrieval, waited anxiously for the results, and received the news that your embryo is chromosomally normal and ‘healthy.’ So why didn’t it become a successful pregnancy?
This heartbreaking paradox is one of the most confusing hurdles in modern fertility treatment. When patients undergo standard pre-implantation genetic testing (PGT-A), they often assume an embryo labeled “normal” guarantees a healthy pregnancy. Yet, as today’s guest explains, even fully tested euploid embryos fail to result in a live birth 40% to 50% of the time.
Jeremy Grushcow, founder and CEO of Juniper Genomics, shares the limitations of standard pre-implantation genetic testing, how Juniper is helping families get deeper genomic clarity, and how PGT-A acts like a quick headcount of chromosomes, confirming whether all 46 “books” are present on the shelf, but it never opens those books to read the genetic text inside. Even with all 46 chromosomes in place, hidden sequence-level “typos” or more technically, reduced viability variants within vital developmental genes, can quietly halt an embryo’s growth.
Jeremy’s dedication to this field is deeply personal: during his PhD in molecular genetics, his family tragically lost a young relative to a sudden cardiac event caused by an undetected single-gene disorder. That loss illuminated the life-saving importance of identifying hidden risks early and stayed with him through careers in law and population genetics. When a clinician later challenged him on why he would “medicalize” pregnancy, Jeremy was galvanized to act.
Embryos can be screened for monogenic conditions through PGT-M, but that requires families knowing that they’re at an increased risk of passing on a specific condition at the start. Through PGT-G testing, Juniper takes the books off the shelf, opens them up, and reads the actual letters across all 3 billion base pairs of DNA to detect reduced viability variants that contribute to unexplained pregnancy loss and implantation failures. And while sequencing embryos through PGT-G is at the core of Juniper Genomics’ mission, their work extends well beyond the embryo stage. Recognizing that embryo quality is only one part of the fertility equation, they tackle unexplained transfer failures and pregnancy loss from multiple angles including parental blood testing, RNA transcriptome data, and more so that families, clinicians, and payers can choose confidence over uncertainty at every step.
Jeremy Grushcow co-founded Juniper Genomics with a mission to improve IVF outcomes, reducing the financial and emotional burden on patients. Under Jeremy’s leadership, Juniper validated and launched the world’s first whole genome and transcriptome embryo test, now in use with partner clinics across the US and Canada. Prior to Juniper, Jeremy was an Operating Partner at Cyclica (later acquired by Recursion) and the Chief Business Officer at Sequence Bio, a population genetics and drug discovery company, where he participated in YCombinator’s S19 cohort. Jeremy earned his Ph.D. in Molecular Genetics and Cell Biology studying meiotic recombination in Doug Bishop’s lab at The University of Chicago, where he also earned his law degree, and he has published papers on DNA repair, bioethics, cancer gene therapy and patent law.
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