U.S. flag

An official website of the United States government

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Genetic Alliance; The New York-Mid-Atlantic Consortium for Genetic and Newborn Screening Services. Understanding Genetics: A New York, Mid-Atlantic Guide for Patients and Health Professionals. Washington (DC): Genetic Alliance; 2009 Jul 8.

Cover of Understanding Genetics

Understanding Genetics: A New York, Mid-Atlantic Guide for Patients and Health Professionals.

Show details


Inheritance Patterns

It is important to understand the basic laws of inheritance to appreciate how conditions are passed on in a family. An accurate family health history is a valuable tool to illustrate how conditions are passed down through generations.

A person has two copies of almost every gene, one copy from mom and one copy from dad. Scientists have studied human genes to learn how they normally work and how changes in genes can change how they work. Some changes are very minor and do not affect the way a gene works. These changes are often called single nucleotide polymorphisms (SNPs, pronounced “snips”) or gene variants. Other changes, called mutations, affect how a gene works and can lead to disease.

For some conditions, family members with the same mutation may not have the same symptoms. For other conditions, individuals with different mutations can have similar characteristics. This is because gene expression is influenced by genes, as well as by the environment.

Diseases caused by mutations in a single gene are usually inherited in a simple pattern, depending on the location of the gene and whether one or two normal copies of the gene are needed. This is often referred to as Mendelian inheritance because Gregor Mendel first observed these patterns in garden pea plants. Most single gene disorders are rare; but, in total, they affect millions of people in the United States.

Several basic modes of inheritance exist for single-gene disorders: autosomal dominant, autosomal recessive, X-linked dominant, and X-linked recessive. However, not all genetic conditions will follow these patterns, and other rare forms of inheritance such as mitochondrial inheritance exist. (See table at the end of this section.)

Inheritance PatternCharacteristicsDisease Examples
Autosomal DominantEach affected person usually has an affected parent; occurs in every generationHuntington’s disease, neurofibromatosis, achondroplasia, familial hypercholesterolemia
Autosomal RecessiveBoth parents of an affected person are carriers; not typically seen in every generationTay-Sachs disease, sickle cell anemia, cystic fibrosis, phenylketonuria (PKU)
X-linked DominantFemales are more frequently affected because all daughters and no sons of an affected man will be affected; can have affected males and females in same generation if the mother is affectedHypophatemic rickets (vitamin Dresistant rickets), ornithine transcarbamylase deficiency
X-linked RecessiveMales are more frequently affected; affected males often present in each generationHemophilia A, Duchenne muscular dystrophy
MitochondrialCan affect both males and females, but only passed on by females because all mitochondria of all children come from the mother; can appear in every generationLeber’s hereditary optic neuropathy, Kearns-Sayre syndrome

Dominant mutations are expressed when only one copy of that mutation is present. Therefore, anyone who inherits one dominant disease mutation such as the mutation for Huntington’s disease will have that disease. Dominantly inherited genetic diseases tend to occur in every generation of a family. Each affected person usually has one affected parent. However, dominant mutations can also happen in an individual for the first time, with no family history of the condition (spontaneous mutation).

Recessive mutations require two mutated copies for disease to develop. Recessive genetic diseases are typically not seen in every generation of an affected family. The parents of an affected person are generally carriers: unaffected people who have a copy of a mutated gene. If both parents are carriers of the same mutated gene and both pass it to the child, the child will be affected.

Inheritance patterns differ for genes on sex chromosomes (chromosomes X and Y) compared to genes located on autosomes, non-sex chromosomes (chromosomes numbers 1-22). This is due to the fact that, in general, females carry two X chromosomes (XX), while males carry one X and one Y chromosome (XY). Therefore, females carry two copies of each X-linked gene, but males carry only one copy each of X-linked and Y-linked genes. Females carry no copies of Y-linked genes.

Diseases caused by mutated genes located on the X chromosome can be inherited in either a dominant or recessive manner. Since males only have one X chromosome, any mutated gene on the X chromosome, dominant or recessive, will result in disease. Because females have two copies of X-linked genes, they will not be affected by inheriting of a single recessive mutation on an X-linked gene. For X-linked recessive diseases to occur in females, both copies of the gene must be mutated. Families with an X-linked recessive disorder often have affected males, but rarely affected females, in each generation.

For X-linked dominant diseases, however, a mutation in one copy of an X-linked gene will result in disease for both males and females. Families with an X-linked dominant disorder often have both affected males and affected females in each generation.

A striking characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons; fathers only pass X chromosomes to their daughters and Y chromosomes to their sons. In contrast, mothers pass X-linked genes to both sons and daughters.


  1. GeneTests www.genetests.org.
  2. Online Mendelian Inheritance in Man (OMIM) www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM.
Copyright © 2008, Genetic Alliance.

All Genetic Alliance content, except where otherwise noted, is licensed under a Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Bookshelf ID: NBK115561


  • PubReader
  • Print View
  • Cite this Page
  • PDF version of this title (22M)

Other titles in this collection

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...