A 50-year-old man has been diagnosed with MELAS syndrome. His wife is phenotypically normal, and there is no history of MELAS syndrome in either of their families. The couple is concerned about whether their children will develop the disease. As a genetic counselor, what will you tell them? Would your answer change if it were the mother who exhibited disease symptoms rather than the father?

Sanders 3rd Edition
Ch. 17 - Organelle Inheritance and the Evolution of Organelle Genomes
Problem 19What is the most likely mode of inheritance for the trait depicted in the following human pedigree?

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Key Concepts
Pedigree Analysis
Modes of Inheritance
Dominance and Recessiveness
The first person in a family to exhibit Leber hereditary optic neuropathy (LHON) was II-3 in the pedigree shown below, and all of her children also exhibited the disease. Provide two possible explanations as to why II-3's mother (I-1) did not exhibit symptoms of LHON.
The following pedigree shows a family in which several individuals exhibit symptoms of the mitochondrial disease MERRF. Two siblings (II-2 and II-5) approach you to inquire about whether their children will also be afflicted with MERRF. What do you tell them?
In 1918, the Russian tsar Nicholas II was deposed, and he and his family were reportedly executed and buried in a shallow grave. During this chaotic time, rumors abounded that the youngest daughter, Anastasia, had escaped. In 1920, a woman in Germany claimed to be Anastasia. In 1979, remains were recovered for the tsar, his wife (the Tsarina Alexandra), and three of their children, but not Anastasia. How would you evaluate the claim of the woman in Germany?
The dodo bird (Raphus cucullatus) lived on the Mauritius Islands until the arrival of European sailors, who quickly hunted the large, placid, flightless bird to extinction. Rapid morphological evolution such as often accompanies island isolation had caused the bird's huge size and obscured its physical resemblance to any near relatives. However, sequencing of mitochondrial DNA from dodo bones reveals that they were pigeons, closely related to the Nicobar pigeon from other islands in the Indian Ocean. Why was mitochondrial DNA suited to the study of this extinct species?
Cytoplasmic male sterility (CMS) in plants has been exploited to produce hybrid seeds. Specific CMS alleles in the mitochondrial genome can be suppressed by specific dominant alleles in the nuclear genome, called Restorer of fertility alleles, RF. Consider the following cross:
♀CMS 1Rf 1/Rf1 rf2/rf2 × ♂CMS2rf 1/rf1 Rf2/Rf2
What genotypes and phenotypes do you expect in the F₁? If some of the F₁ plants are male fertile, what genotypes and phenotypes do you expect in the F₂?