How Surbhi Sarna built a $275M biotech company from nothing

Executive overview

A high-school cancer scare left Surbhi Sarna facing an unacceptable diagnostic gap: no reliable way to tell whether an ovarian cyst was malignant without risking fertility or spreading cancer cells. She founded nVision Medical at 24, with a bachelor's degree and no medical credentials, to build a device that could collect cells from the fallopian tube for cancer screening.

After 50+ investor rejections and $20M in venture capital, nVision achieved FDA clearance as the first device of its kind. Boston Scientific acquired it for $275M in 2018.

The problem you live through is the clearest signal of the problem worth solving.

The personal origin of nVision

• Hospitalised in high school with severe pain; diagnosis took a week of uncertainty
• Ovarian cysts: ultrasound shows a mass exists but cannot confirm malignancy
• Blood test accuracy was no better than a coin toss; biopsy risked spreading cancer cells
• Surgery often required removing the entire ovary, impacting fertility and ovarian function
• Family chose to wait; cyst was benign — but the diagnostic gap was undeniable
• Wrote in her college application that she wanted to start a women's health company

Entering the industry without credentials

• Worked as an engineer at Abbott Vascular, then a smaller device startup
• Left at 24 despite good employment and a stable personal life — the drive to start outweighed caution
• No MBA, PhD, or MD; only a bachelor's degree entering a credential-heavy field

Early customer discovery

• Realised she had no gynecologist contacts except her own doctor
• Called her gynaecologist under false pretences and pitched the concept mid-appointment
• Dr Cook agreed to meet at a café; liked the concept and introduced her to physicians at UC Davis and Stanford
• Personal network, not a Rolodex, is the right starting point — ask for introductions, keep going until you reach the right people

Fundraising as a first-time founder

• Rejected at least 50 times before closing a seed round
• Investors dismissed women's health as too small a market; some used the term "bikini medicine"
• Two women investors each committed conditionally — if a third came in, they were in
• Raised ~$20M in total venture capital after the seed round

Building and exiting the company

• Took the device from prototype through multiple clinical studies to FDA clearance
• First and only device cleared to collect cells from the fallopian tube for malignancy evaluation
• Goal was always to get the product to patients; acquisition was not the original plan
• Boston Scientific emailed an unsolicited offer of $275M after reading the clinical data
• Signed the acquisition paperwork holding her son on his first birthday

Joining YC as a Group Partner

• Introduced to Jared Friedman immediately after the sale
• YC wanted its first healthcare and biotech-focused Group Partner
• Speaking to founders for the first time made her realise her failures and mistakes had direct transfer value
• Now evaluates founders on depth of problem knowledge and founder-problem fit, not degrees
• Looks for a real need, a big problem, and a founder who believes in the solution more than anyone else