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This occurs due to nondisjunction, in which one or more homologous pairs of chromosomes do not separate during anaphase I, or sister chromatids do not separate properly during anaphase II of meiosis. The resulting daughter cells (gametes) will have either 22 or 24 chromosomes. If the gamete with 22 chromosomes unites with a normal gamete with 23 chromosomes, the offspring will have 45 chromosomes (23 + 22). If the gamete with 24 chromosomes unites with a normal gamete, the offspring will have 47 chromosomes (23 + 24). These are usually lethal conditions.

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