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Occasionally, however, two or more types of mtDNA are present termed heteroplasmy. This can result from a combination of mutant and wild-type mtDNA molecules or from a combination of wild-type mtDNA variants. As heteroplasmy can result in mitochondrial disease, various mechanisms exist in the natural fertilization process to ensure the maternal-only transmission of mtDNA and the maintenance of homoplasmy in future generations. However, there is now an increasing use of invasive oocyte reconstruction protocols, which tend to bypass mechanisms for the maintenance of homoplasmy, potentially resulting in the transmission of either form of mtDNA heteroplasmy. Indeed, heteroplasmy caused by combinations of wild-type variants has been reported following cytoplasmic transfer (CT) in the human and following nuclear transfer (NT) in various animal species. Other techniques, such as germinal vesicle transfer and pronuclei transfer, have been proposed as methods of preventing transmission of mitochondrial diseases to future generations. However, resulting embryos and offspring may contain mtDNA heteroplasmy, which itself could result in mitochondrial disease. It is therefore essential that uniparental transmission of mtDNA is ensured before these techniques are used therapeutically.<\/jats:p>","DOI":"10.1093\/humupd\/dml011","type":"journal-article","created":{"date-parts":[[2006,3,31]],"date-time":"2006-03-31T20:13:11Z","timestamp":1143835991000},"page":"401-415","source":"Crossref","is-referenced-by-count":64,"title":["Transmission of mitochondrial DNA following assisted reproduction and nuclear transfer"],"prefix":"10.1093","volume":"12","author":[{"given":"E.C.","family":"Spikings","sequence":"first","affiliation":[{"name":"The Mitochondrial and Reproductive Genetics Group, The Medical School, University of Birmingham, Birmingham B15 2TT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Alderson","sequence":"additional","affiliation":[{"name":"The Mitochondrial and Reproductive Genetics Group, The Medical School, University of Birmingham, Birmingham B15 2TT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.C.St.","family":"John","sequence":"additional","affiliation":[{"name":"The Mitochondrial and Reproductive Genetics Group, The Medical School, University of Birmingham, Birmingham B15 2TT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2006,3,31]]},"reference":[{"key":"2026041313284583700_ALAM-ET-AL-2003","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1093\/nar\/gkg251","volume":"31","author":"Alam","year":"2003","journal-title":"Nucleic Acids 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