Heredity is the passing on of traits from parents to their offspring. For humans, through sexual reproduction, the offspring acquire the genetic information of their parents. Through heredity, variations between individuals can accumulate and cause species to evolve by natural selection.

Video 1. Heritability explained.

Gametes

There are two types of sex cells or gametes involved in reproduction: the male gametes, or sperm, and female gametes, or ova. The male gametes are produced in the testes through a process called spermatogenesis, which begins at about 12 years of age. The female gametes, which are stored in the ovaries, are present at birth but are immature. Each ovary contains about 250,000 ova but only about 400 of these will become mature eggs (Mackon & Fauser, 2000; Rome, 1998). Beginning at puberty, one ovum ripens and is released about every 28 days, a process called oogenesis.

After the ovum or egg ripens and is released from the ovary, it is drawn into the fallopian tube and in 3 to 4 days, reaches the uterus. It is typically fertilized in the fallopian tube and continues its journey to the uterus. At ejaculation, millions of sperm are released into the vagina, but only a few reach the egg and typically, only one fertilizes the egg. Once a single sperm has entered the wall of the egg, the wall becomes hard and prevents other sperm from entering. After the sperm has entered the egg, the tail of the sperm breaks off and the head of the sperm, containing the genetic information from the father, unites with the nucleus of the egg. As a result, a new cell is formed. This cell, containing the combined genetic information from both parents, is referred to as a zygote.

Video 2. Fertilization shows how one single sperm survives the long and treacherous journey to fertilize the mother’s egg.

Chromosomes

While other normal human cells have 46 chromosomes (or 23 pairs), gametes contain 23 chromosomes. Chromosomes are long threadlike structures found in a cell nucleus that contains genetic material known as deoxyribonucleic acid (DNA). DNA is a helix-shaped molecule made up of nucleotide base pairs [adenine (A), guanine (G), cytosine (C), and thymine (T)]. In each chromosome, sequences of DNA make up genes that control or partially control a number of visible characteristics, known as traits, such as eye color, hair color, and so on. A single gene may have multiple possible variations or alleles. An allele is a specific version of a gene. So, a given gene may code for the trait of hair color, and the different alleles of that gene affect which hair color an individual has.

In a process called meiosis, segments of the chromosomes from each parent form pairs, and genetic segments are exchanged as determined by chance. Because of the unpredictability of this exchange, the likelihood of having offspring that are genetically identical (and not twins) is one in trillions (Gould & Keeton, 1997). Genetic variation is important because it allows a species to adapt so that those who are better suited to the environment will survive and reproduce, which is an important factor in natural selection.

Video 3. Meiosis explained.

Genotypes and Phenotypes

When a sperm and egg fuse, their 23 chromosomes pair up and create a zygote with 23 pairs of chromosomes. Therefore, each parent contributes half the genetic information carried by the offspring; the resulting physical characteristics of the offspring (called the phenotype) are determined by the interaction of genetic material supplied by the parents (called the genotype). A person’s genotype is the genetic makeup of that individual. Phenotype, on the other hand, refers to the individual’s inherited physical characteristics.

Look in the mirror. What do you see, your genotype or your phenotype? What determines whether or not genes are expressed? Actually, this is quite complicated. Some features follow the additive pattern which means that many different genes contribute to a final outcome. Height and skin tone are examples. In other cases, a gene might either be turned on or off depending on several factors, including the gene with which it is paired or the inherited epigenetic tags.

Determining the Sex of the Child

Twenty-two of those chromosomes from each parent are similar in length to a corresponding chromosome from the other parent. However, the remaining chromosome looks like an X or a Y. Half of the male’s sperm contains a Y chromosome and half contain an X. All of the ova contain X chromosomes. If the child receives the combination of XY, the child will be genetically male. If it receives the XX combination, the child will be genetically female.

Many potential parents have a clear preference for having a boy or a girl and would like to determine the sex of the child. Through the years, a number of tips have been offered for potential parents to maximize their chances of having either a son or daughter as they prefer. For example, it has been suggested that sperm that carry a Y chromosome are more fragile than those carrying an X. So, if a couple desires a male child, they can take measures to maximize the chance that the Y sperm reaches the egg. This involves having intercourse 48 hours after ovulation, which helps the Y sperm have a shorter journey to reach the egg, douching to create a more alkaline environment in the vagina, and having the female reach orgasm first so that sperm are not pushed out of the vagina during orgasm. Today, however, there is new technology available that makes it possible to isolate sperm containing either an X or a Y, depending on the preference, and use that sperm to fertilize a mother’s egg.

Genetic Variation and Inheritance

Genetic variation, the genetic difference between individuals, is what contributes to a species’ adaptation to its environment. In humans, genetic variation begins with an egg, several million sperm, and fertilization. The egg and the sperm each contain 23 chromosomes, which make up our genes. A single gene may have multiple possible variations or alleles (a specific version of a gene), resulting in a variety of combinations of inherited traits.

Genetic inheritance of traits for humans is based upon Gregor Mendel’s model of inheritance. For genes on an autosome (any chromosome other than a sex chromosome), the alleles and their associated traits are autosomal dominant or autosomal recessive. In this model, some genes are considered dominant because they will be expressed. Others, termed recessive, are only expressed in the absence of a dominant gene. Some characteristics which were once thought of as dominant-recessive, such as eye color, are now believed to be a result of the interaction between several genes (McKusick, 1998). Dominant traits include curly hair, facial dimples, normal vision, and dark hair. Recessive characteristics include red hair, pattern baldness, and nearsightedness.

Sickle cell anemia is an autosomal recessive disease; Huntington’s disease is an autosomal dominant disease. Other traits are a result of partial dominance or co-dominance in which both genes are influential. For example, if a person inherits both recessive genes for cystic fibrosis, the disease will occur. But if a person has only one recessive gene for the disease, the person would be a carrier of the disease.

In this example, we will call the normal gene “N,” and the gene for cystic fibrosis “c.” The normal gene is dominant, which means that having the dominant allele either from one parent (Nc) or both parents (NN) will always result in the phenotype associated with the dominant allele. When someone has two copies of the same allele, they are said to be homozygous for that allele. When someone has a combination of alleles for a given gene, they are said to be heterozygous. For example, cystic fibrosis is a recessive disease which means that an individual will only have the disease if they are homozygous for that recessive allele (cc).

Imagine that a woman who is a carrier of the cystic fibrosis gene has a child with a man who also is a carrier of the same disease. What are the odds that their child would inherit the disease? Both the woman and the man are heterozygous for this gene (Nc).  We can expect the offspring to have a 25% chance of having cystic fibrosis (cc), a 50% chance of being a carrier of the disease (Nc), and a 25% chance of receiving two normal copies of the gene (NN).

Where do harmful genes that contribute to diseases like cystic fibrosis come from? Gene mutations provide one source of harmful genes. A mutation is a sudden, permanent change in a gene. While many mutations can be harmful or lethal, once in a while a mutation benefits an individual by giving that person an advantage over those who do not have the mutation. Recall that the theory of evolution asserts that individuals best adapted to their particular environments are more likely to reproduce and pass on their genes to future generations. In order for this process to occur, there must be competition—more technically, there must be variability in genes (and resultant traits) that allow for variation in adaptability to the environment. If a population consisted of identical individuals, then any dramatic changes in the environment would affect everyone in the same way, and there would be no variation in selection. In contrast, diversity in genes and associated traits allow some individuals to perform slightly better than others when faced with environmental change. This creates a distinct advantage for individuals best suited for their environments in terms of successful reproduction and genetic transmission.

Video 4. An Introduction to Mendelian Genetics demonstrates another example of the interaction of alleles using the Punnett square.

Sex-Linked Traits

Sex-linked traits are genes located on a sex chromosome (the 23rd pair). In humans, the term generally refers to traits that are influenced by genes on the X chromosome. This is because the X chromosome is large and contains many more genes than the smaller Y chromosome. In a sex-linked disease, it is usually males who are affected because they have a single copy of the X chromosome that carries the mutation. In females, the effect of the mutation may be masked by the second healthy copy of the X chromosome.

Figure 4. Hemophilia is an example of a sex-linked trait, as are color blindness, congenital night blindness, some high blood pressure genes, Duchenne muscular dystrophy, and also Fragile X syndrome. This exemplifies how the gene for hemophilia may be passed from one parent to their sons and daughters.

Video 5. Sex-Linked Traits explains the traits carried on the 23rd pair of chromosomes and how these

Chromosomal Abnormalities and Genetic Testing

A chromosomal abnormality occurs when a child inherits too many or too few chromosomes. The most common cause of chromosomal abnormalities is the age of the mother. A 20-year-old woman has a 1 in 800 chance of having a child with a common chromosomal abnormality. A woman of 44, however, has a one in 16 chance. It is believed that the problem occurs when the ovum is ripening prior to ovulation each month. As the mother ages, the ovum is more likely to suffer abnormalities at this time.

Another common cause of chromosomal abnormalities occurs because the gametes do not divide evenly when they are forming. Therefore, some cells have more than 46 chromosomes. In fact, it is believed that close to half of all zygotes have an odd number of chromosomes. Most of these zygotes fail to develop and are spontaneously aborted by the body. If the abnormal number occurs on pair # 21 or # 23, however, the individual may have certain physical or other abnormalities.

An altered chromosome structure may take several different forms, and result in various disorders or malignancies:

•  Deletions: A portion of the chromosome is missing or deleted. Known disorders in humans include Wolf-Hirschhorn syndrome, which is caused by partial deletion of the short arm of chromosome 4; and Jacobsen syndrome, also called the terminal 11q deletion disorder.
• Duplications: A portion of the chromosome is duplicated, resulting in extra genetic material. Known human disorders include Charcot-Marie-Tooth disease type 1A, which may be caused by duplication of the gene encoding peripheral myelin protein 22 (PMP22) on chromosome 17.
  

  Figure 6. The two major two-chromosome mutations: insertion (1) and Translocation (2).

• Translocations: A portion of one chromosome is transferred to another chromosome. There are two main types of translocations:
  • Reciprocal translocation: Segments from two different chromosomes have been exchanged.
  • Robertsonian translocation: An entire chromosome has attached to another at the centromere – in humans, these only occur with chromosomes 13, 14, 15, 21, and 22.
• Inversions: A portion of the chromosome has broken off, turned upside down, and reattached, therefore the genetic material is inverted.
• Insertions: A portion of one chromosome has been deleted from its normal place and inserted into another chromosome.
• Rings: A portion of a chromosome has broken off and formed a circle or ring. This can happen with or without loss of genetic material.
• Isochromosome: Formed by the mirror image copy of a chromosome segment including the centromere.

One of the most common chromosomal abnormalities is on pair # 21. Trisomy 21 occurs when there are three rather than two chromosomes on #21. A person with Down syndrome has distinct facial features, intellectual disability, and oftentimes heart and gastrointestinal disorders. Symptoms vary from person to person and can range from mild to severe. With early intervention, the life expectancy of persons with Down syndrome has increased in recent years. Keep in mind that there is as much variation in people with Down Syndrome as in most populations and those differences need to be recognized and appreciated.

When the chromosomal abnormality is on pair #23, the result is a sex-linked chromosomal abnormality. A person might have XXY, XYY, XXX, XO, or 45 or 47 chromosomes as a result. Two of the more common sex-linked chromosomal disorders are Turner syndrome and Klinefelter syndrome. Turner’s syndrome occurs in 1 of every 2,500 live female births (Carroll, 2007) when an ovum that lacks a chromosome is fertilized by a sperm with an X chromosome. The resulting zygote has an XO composition. Fertilization by a Y sperm is not viable. Turner syndrome affects cognitive functioning and sexual maturation. The external genitalia appears normal, but breasts and ovaries do not develop fully and the woman does not menstruate. Turner’s syndrome also results in short stature and other physical characteristics.  Klinefelter syndrome (XXY) occurs in 1 out of 700 live male births and results when an ovum containing an extra X chromosome is fertilized by a Y sperm. The Y chromosome stimulates the growth of male genitalia, but the additional X chromosome inhibits this development. An individual with Klinefelter syndrome has some breast development, infertility (this is the most common cause of infertility in males), and has low levels of testosterone.

Prenatal Testing

Prenatal testing consists of prenatal screening and prenatal diagnosis, which are aspects of prenatal care that focus on detecting problems with the pregnancy as early as possible. These may be anatomic and physiologic problems with the health of the zygote, embryo, or fetus, either before gestation even starts or as early in gestation as practical. Prenatal screening focuses on finding problems among a large population with affordable and noninvasive methods. The most common screening procedures are routine ultrasounds, blood tests, and blood pressure measurement. Prenatal diagnosis focuses on pursuing additional detailed information once a particular problem has been found, and can sometimes be more invasive.

Screening can detect problems such as neural tube defects, anatomical defects, chromosome abnormalities, and gene mutations that would lead to genetic disorders and birth defects, such as spina bifida, cleft palate, Downs Syndrome, Tay–Sachs disease, sickle cell anemia, thalassemia, cystic fibrosis, muscular dystrophy, and fragile X syndrome. Some tests are designed to discover problems that primarily affect the health of the mother, such as PAPP-A to detect pre-eclampsia or glucose tolerance tests to diagnose gestational diabetes. Screening can also detect anatomical defects such as hydrocephalus, anencephaly, heart defects, and amniotic band syndrome.

Common prenatal diagnosis procedures include amniocentesis and chorionic villus sampling. Because of the miscarriage and fetal damage risks associated with amniocentesis and CVS procedures, many women prefer to first undergo screening so they can find out if the fetus’ risk of birth defects is high enough to justify the risks of invasive testing. Screening tests yield a risk score which represents the chance that the baby has the birth defect; the most common threshold for high-risk is 1:270. A risk score of 1:300 would, therefore, be considered low-risk by many physicians. However, the trade-off between the risk of birth defects and risk of complications from invasive testing is relative and subjective; some parents may decide that even a 1:1000 risk of birth defects warrant an invasive test while others wouldn’t opt for an invasive test even if they had a 1:10 risk score.

There are three main purposes of prenatal diagnosis: (1) to enable timely medical or surgical treatment of a condition before or after birth, (2) to give the parents the chance to abort a fetus with the diagnosed condition, and (3) to give parents the chance to prepare psychologically, socially, financially, and medically for a baby with a health problem or disability, or for the likelihood of stillbirth. Having this information in advance of birth means that healthcare staff, as well as parents, can better prepare themselves for the delivery of a child with a health problem. For example, Down Syndrome is associated with cardiac defects that may need intervention immediately upon birth.

The American College of Obstetricians and Gynecologists (ACOG) guidelines currently recommend that all pregnant women, regardless of age, be offered invasive testing to obtain a definitive diagnosis of certain birth defects. Therefore, most physicians offer diagnostic testing to all their patients, with or without prior screening, and let the patient decide.