This leaflet gives you information about what recessive inheritance means and how recessive conditions are inherited. To understand recessive inheritance, it is first helpful to know about genes and chromosomes.

Genes and chromosomes

Our bodies are made up of millions of cells. Most cells contain a complete set of genes. Genes act like a set of instructions, controlling our growth and how our bodies work. They are also responsible for many of our characteristics, such as our eye colour, blood type and height. We have thousands of genes. We each inherit two copies of most genes, one copy from our mother and one copy from our father. That is why we often have similar characteristics to both of them.

Genes are located on small thread-like structures called chromosomes. Usually we have 46 chromosomes in most cells. We inherit one set of 23 chromosomes from our mother and one set of 23 chromosomes from our father. So we have two sets of 23 chromosomes, or 23 pairs.

This picture shows a cell, DNA and chromosomes


Sometimes, there is a change (mutation) in one copy of a gene which stops it from working properly.

If this occurs in only one recessive gene, and the person has another normal copy, this will not usually cause a genetic condition.

What is autosomal recessive inheritance?

Some conditions are inherited as recessive conditions. This means that a person must inherit two changed (mutated) copies of the same gene (one changed copy from each parent) in order to have the condition. If a person inherits one changed copy and one normal copy, then in most cases that person will be a healthy carrier because the normal copy compensates for the changed copy. Being a carrier means that you do not have the condition, but carry a changed copy of the gene on one of a pair of genes. Examples of autosomal recessive conditions include cystic fibrosis and sickle cell anaemia.

How recessive conditions are passed on from parent to child 

If both partners are carriers of the same changed gene, they may pass on either their normal gene or their changed gene to their child. This occurs randomly.

Each child of parents who both carry the same changed gene therefore has a 25% (one in four) chance of inheriting a changed gene from both parents and being affected by the condition. This also means that there is a 75% (three in four) chance that a child will not be affected by the condition.

This chance remains the same in every pregnancy and is the same for boys or girls. There is also a 50% (two in four) chance that the child will inherit just one copy of the changed gene from a parent. If this happens, then they will be healthy carriers like their parents. Lastly, there is a 25% (one in four) chance that the child will inherit both normal copies of the gene. In this case the child will not have the condition, and will not be a carrier.
It is also the case that two thirds of healthy children will carry the hanged gene, one third will not.

These possible outcomes occur randomly. The chance remains the same in every pregnancy and is the same for boys and girls.


Carrier testing and tests in pregnancy

A number of options may be available for people who have a family history of a recessive genetic condition. Carrier testing may be available to see if the couple are both carriers of the changed gene. This information may be useful when planning pregnancies. For some recessive conditions, it is possible to have a test in pregnancy to see if the baby has inherited the condition, i.e. they have inherited the changed (mutated) gene from both parents. This is something you should discuss with your doctor or healthcare professional.

Other family members

If someone in the family has a recessive condition or is a carrier, you may wish to discuss this with other family members. This gives them the opportunity to have a blood test to see if they are also carriers, if they wish. This information may also be useful in helping diagnose other family members. This might be particularly important to family members who already have children, or are likely to have children in the future. Some people find it difficult to tell other members of the family about a genetic condition. They may be worried about causing anxiety in the family. In some families, people have lost touch with relatives and may feel it is difficult to contact them. Genetic specialists often have a lot of experience with families in these situations and may be able to offer you help in discussing the situation with other family members.

Points to remember:

  • A person must inherit two copies of a changed gene, one from each parent, in order to be affected by the condition (25% chance). If a person inherits only one changed gene then they will be a carrier (50% chance). These outcomes occur randomly. They remain the same in every pregnancy and are the same for boys and girls, i.e. the chance of a couple who are both carriers of the condition having an affected child will be 25% for each pregnancy, regardless of the outcome in the previous pregnancy
  • A changed gene cannot be corrected – it is present for life. However, gene therapy is being developed which may help treat the condition in the future
  • A changed gene is not something that can be caught from other people. They can still be a blood donor, for example
  • People often feel guilty about a genetic condition which runs in the family. It is important to remember that it is no one’s fault and no one has done anything to cause it to happen

Useful links

First published in 2007. This leaflet was developed by Genetic Alliance UK, modified from leaflets produced by Guy’s and St Thomas’ Hospital, London and the London IDEAS Genetic Knowledge Park, according to their quality standards. This work was supported by EuroGentest, an EU-FP6 supported NoE contract number 512148.

Reviewed and updated January 2017 with help from Prof. Shirley Hodgson, Emeritus at St. George’s, University of London and members of SWAN UK (syndromes without a name) and Genetic Alliance UK.

To be reviewed January 2020


















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