Counsyl is TEN TODAY!
On October 24th, 2007, we incorporated Counsyl in our Stanford West apartment.  And today, we’re celebrating ten years.
We didn’t originally set out to run a women’s health screening laboratory — we started Counsyl with the idea that the “genome was the next internet.”
Put simply, instrument manufacturers like Illumina developed tools that made reading long stretches of your genetic code remarkably affordable.  From 2001 to 2011, these advances reduced the price of sequencing a genome from $95,263,072 to $7,743; if that kind of pricing happened in cars, a $30K car would cost $2.44.¹
We thought we could simply write “applications” on top of your genetic code, just like you can write amazing applications like Lyft or Uber for iOS today.

And wow, were we off base!  As it turns out, our initial approach was somewhat backwards.  Originally, we tried to discover the genetic roots of very complex cognitive disorders, like Parkinson’s and Alzheimer’s.  The roots of these diseases are spread across potentially thousands of “bits” in your genetic code.
We ran into two major problems:  
First, we couldn’t discover the “signature” that predicted whether you would get Parkinson’s or Alzheimer’s.  
And second, we learned that wasn’t really strong clinical utility, except in a very academic sense.  Even if we had discovered a signature, there was very little meaningful clinical action you could take at that time.

But, we kept thinking of different applications, and hit upon a MUCH SIMPLER, but unloved idea – we could screen for simpler, recessive diseases.

 
If you and your partner have a bit “flipped” in your genetic code, then you have a specific mutation. In that case, you’re what’s called an “at-risk” couple, meaning you would have an approximately 25% chance of conceiving a child with a potentially serious and fatal disease.  However, if you learn your risk in advance of conception, you can pursue specific fertility treatments to improve your chances of a healthy delivery. What’s more — even if you get this sort of testing during pregnancy, you have many more options available to you.  Carrier screening at the time was considered very “boring” to cool genomicist types, but we found it emotionally appealing and practical.

This rediscovery of the clinical value of carrier screening led us to launch expanded carrier screening, which we now call Counsyl Foresight™, to prospective parents in 2009.  
We quickly learned that OB/GYNs, prospective moms and prospective dads weren’t all that interested in genomics, or sequencing, or any of the mechanics of how our technology works; those healthcare providers and patients were interested in whether we could deliver answers to questions like: 

“Are my spouse and I at-risk for having a child with a serious disease? If so, what can we do?”  

Since we ran our first tests in 2009, we’ve been absolutely motivated to deliver answers to those crucial questions.
Along the way, we discovered a fundamental (and apparently age-old) problem with our original approach of trying to “write applications on top of the human genome.”  We were starting with the solution and then, only after the fact, trying to figure out the problem we should solve.  
In starting Counsyl, we got a very, very practical education on how important it is to start with the problem first, and then engineer the solution. That approach has made all the difference in Foresight’s value to patients.

So while we didn’t set out originally to run a women’s health screening laboratory, we quickly fell in love with the inherent meaning of helping healthcare providers and patients answer critical questions.

Since starting Counsyl in 2007 and launching our first carrier screening test in 2009, we’re proud to have:

• Screened more than 850,000 patients — providing important information to people and families about reproductive health and hereditary cancer risk so they can make informed choices and plan for the future
• Served more than 17,000 healthcare providers — partnering with them every step of the way to make it easy and practical to offer patients the very best testing
• Provided more than 60,000 genetic counseling sessions — helping people understand high-stakes medical results with a human touch

There are hundreds of events that happened in Counsyl that brought us where we are today, but we want to share some of the biggest milestones along the way:

 
THANK YOU to every Counsyl patient and healthcare provider, who trusted us at a key time.
THANK YOU to every Counsyl employee. Every hour, every extra effort matters to our patients and healthcare providers.
Carrier screening ought to be as common as getting folic acid before pregnancy, non-invasive prenatal screening as common as an ultrasound during pregnancy, and hereditary cancer screening as well known as a pap smear in an annual visit.  And in the next decade, we hope to make that a reality.
— Ramji, Rishi and Eric, co-founders
¹https://www.genome.gov/sequencingcostsdata/