The prevalence of heteroplasmy can be studied at many hierarchical levels. with a recent mathematical and experimental metastudy providing evidence for a combination of random partitioning of mtDNAs at cell divisions and random turnover of mtDNA molecules within the cell. In deterministic forces, heteroplasmic entities are subjected to various forms of
natural selection which result in fluctuations in the frequencies of various organellar DNA copies. Both purifying selection and
balancing selection can be present depending on the effects of the various mutant organellar DNA copies and fluctuations in the environment of said entities. Under purifying selection, entities with an excessively high proportion of the deleterious mutant do not reproduce, thereby reducing the frequency of that mutant. Conversely, fluctuations in environmental situations can theoretically favour the co-existence of multiple mutant copies, pushing heteroplasmic frequencies under balancing selection. In
human mitochondrial DNA, microheteroplasmy can include hundreds of independent mutations in one organism, with each mutation usually found in 1–2% of all mitochondrial genomes. Very low-level heteroplasmic variance is present in essentially all individuals, and is likely to be due to both inherited and somatic single base substitutions. Quantification of heteroplasmy can be done through
qPCR with fluorescence detection. In the context of disease, screening procedures can be used to detect the proportion of deleterious organellar DNA copies to determine the potential disease severity.
Preimplantation genetic screening (PGS) can be used to quantify the risk of a child of being affected by a mitochondrial disease. In most cases, a muscle mutation level of approximately 18% or less confers a 95% risk reduction. ==Disease==