When time mattered most: Delivering specialized fetal care for high-risk twin pregnancy

Ashley and Ben Agee were already parents of two young children when they learned they were expecting again in 2013 while living in Jackson Hole, Wyoming. After a miscarriage months earlier, their hope for this pregnancy was simple: a healthy heartbeat.

When the ultrasound confirmed not one baby but two, that hope expanded into joy. Twins felt like a gift—unexpected and deeply welcomed.

That joy shifted abruptly at a routine appointment around 23 weeks, when an ultrasound revealed twin-to-twin transfusion syndrome (TTTS), a rare but serious condition in which identical twins share a placenta. When this occurs, blood flow between the twins can become dangerously unbalanced, putting both babies at risk without timely treatment.

In that moment, Ben and Ashley turned to a guiding principle they had come to trust: asking who a physician would recommend for their own family. The answer brought them back to their hometown and to the UTHealth Houston Fetal Center, where UTHealth Houston physicians specialize in caring for the most complex and time-sensitive fetal conditions at Children’s Memorial Hermann Hospital.

Ben, Ashley, and their two children stayed with Ben’s parents, Richard and Judith Agee, through the remainder of the pregnancy. They relied on that support to navigate an already overwhelming time—something not every family traveling for care can rely on.

In Houston, they were quickly connected with a specialized care team. Their sense of confidence grew when they first met Anthony Johnson, DO, co-director of The Fetal Center and professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at McGovern Medical School at UTHealth Houston.

“When cases like this come to us, they’re often advanced and time-sensitive,” Johnson said. “Our job is to move quickly, be completely transparent with families about what they’re facing, and prepare them for immediate intervention when needed.”

A race against time

The 48 hours between diagnosis and treatment were emotionally intense. Ashley described it as a time of waiting and hoping, supported by a team that was steady and present.

“We were greatly assured by the competence and professionalism of the entire team,” Ben said. “More importantly, in what was an incredibly high-stress situation, the spirit of humanity that came through in every interaction is what carried us through.”

To treat the TTTS, a fetoscopic laser procedure was performed at Children’s Memorial Hermann Hospital, sealing the shared blood vessel connections in the placenta to restore balanced blood flow. Early next morning, an ultrasound confirmed what they had hoped: Blood flow was balanced, and the immediate danger had passed.

“When they told us the procedure had worked—that the babies were going to be okay—it was overwhelming,” Judith said. “After everything leading up to that moment, it felt like such a profound relief.”

“It went from the worst-case scenario to everything being back in balance almost overnight,” Ben said. “After that, getting to watch them grow week by week, it was something we didn’t take for granted.”

More than 10 years later, Penelope and Charlotte, known in the family as “Pippi” and “Lottie,” are thriving. Now in middle school, they are active and fully engaged in the rhythms of everyday life. Ashley sees their personalities as echoes of their earliest days.

“That same spirit of care we were shown is something the girls seem to carry with them,” she explained.

For the Agee family, the experience extended beyond a moment of crisis; it shaped how they think about the care that made it possible.

“As grandparents, you feel both protective and somewhat helpless,” Richard said. “But seeing the level of expertise and commitment from the team, and the way they handled something so complex, left a lasting impression on us.”

Turning gratitude into impact

In the years since, the Agee family has focused on supporting the people, research, and resources that make this level of care possible.

That commitment includes helping families overcome the practical challenges of traveling for care—costs like transportation, lodging, and meals.

“In many cases, the only thing standing in the way of lifesaving care is a plane ticket or a place to stay,” Ashley said.

“What stood out to me is how critical it is to pass this knowledge along,” Richard said. “Not every physician is familiar with TTTS or how to treat it. It’s not enough to know the technique—you have to be able to do it well. That’s why bringing in fellows, training them thoroughly, and helping them carry that knowledge forward is so important.”

This work is supported by ongoing research through the UTHealth Houston Fetal Institute and one of the most comprehensive fellowship programs in the United States at McGovern Medical School.

“We train physicians over several years so they can perform these procedures independently and safely,” Johnson said. “That level of training, combined with ongoing research and coordinated care, allows this kind of treatment to reach more families, not just here, but across the country.”

“They are constantly pushing what’s possible,” Ben said. “Even in the most difficult cases, they are always working to improve outcomes for the next family.”

Because of that commitment—to knowledge, innovation, and compassion—two little girls are not just alive, but flourishing. One family’s experience stands as a quiet testament to what’s possible when medicine, trust, and generosity come together.