Miracle, lucky, fighter, survivor - all are words that could describe Gabriel and Gavin Hansen.

Gabriel and Gavin, identical twins born at the beginning of April, started facing challenges before they even took their first breath. One of them could have died any day while their mother, Janis Hansen, was pregnant with them; they had a surgery that could have killed one of them while they were still in the womb.

Without this surgery and Michael Belfort and Robert Ball, the doctors who performed the procedure, things could have been vastly different.

The surgery was successful. It corrected the problems long enough for the twins to grow and develop properly, and after a stay in the neonatal intensive care unit, the twins went home with parents Janis and Christopher Hansen, both BYU graduates.

Gabriel and Gavin had twin-to-twin transfusion syndrome, a rare and serious condition that only affects identical twins. In this syndrome, an imbalance develops between the circulations of the two twins, which occurs because the babies share one placenta.

The twins also share blood vessel connections on the surface of the placenta, which connect their circulations. This condition occurs in 10 to 15 percent of identical twin pregnancies.

The in-utero surgery involves using a fetoscope and ultrasound to find the shared vessels. After the vessels are found, a laser is used to close the blood vessels that the babies share, connecting their circulations on the surface of the placenta. Choosing the right vessels is the hard part.

"That's the training," Belfort said. "You have to identify the area where vessels are not crossing. ... Look for abnormal single vessels going from one baby to the other."

Everything started out well during the pregnancy. At week eight, Janis Hansen found out she was having twins. Good news.

Over the next eight weeks, though, some issues started appearing, and she was referred to Ball and Belfort, both perinatologists, doctors who deal with high-risk pregnancies. At 16 weeks into the pregnancy, the doctors started noticing signs of the syndrome.

"It was a pretty worrisome time," Janis Hansen said. "This is our first and second. You don't foresee those kinds of complications."

"During that time, they told us there was a fair chance that one of the twins wouldn't be alive the next time we came in," her husband said.

"Every ultrasound was a big deal, to see those hearts beating," Hansen said.

The couple had to decide what action to take one week later. They could either do nothing or have a new in-utero surgery to help correct the problem.

The Hansens decided to go through with the surgery, knowing one of the twins might not make it. The next day, however, the ultrasound showed that both were still alive.

"They [Ball and Belfort] are really great doctors. We have come to really respect them," Janis Hansen said. "I am grateful [to them] for the lives of our little boys."

A year and a half ago, the Hansens would have had to travel to San Francisco, Seattle, Houston or a few other hospitals across the U.S., to have the surgery done. Twenty years ago, the surgery had barely been perfected, with only a handful of patients receiving the procedure.

Janis Hansen is only the seventh mother to have the procedure done in Utah, and the first to have it done at Timpanogos Regional Medical Center in Orem.

"We are just glad they [Ball and Belfort] practice here," Hansen said.

Following the surgery, the twins continued to grow along with each other rather than one growing and one staying small, she explained. That was until around weeks 33 and 34 into the pregnancy when the twins started having discrepancy in their size again. Gabriel's growth continued but Gavin's growth started to level off. The doctors decided it was time to deliver the babies.

"They were less sick," said Dr. Dale Gerstmann, the medical director for the NICU at Timpanogos Regional Medical Center. "I think this [surgery] really did help. The outcome would have been different and not as good."

Gerstmann also stressed the early surgery got rid of a lot of the problems associated with the twin's syndrome.

"We had to learn a lot about this stuff," Hansen said. "We were so uneducated. Even being a nurse and Christopher being interested in health stuff, it still was way beyond our understanding of what was going on."

Gabriel and Gavin were delivered by cesarean section on April 2. They weighed 5 pounds, 3 ounces and 3 pounds, 11 ounces, respectively. The twins then stayed in the neonatal intensive care unit for the next 40 days, thriving and growing, and were brought home May 10. Gabriel and Gavin now weigh 7 pounds 3 ounces and 6 pounds 9 ounces, respectively.

The twins were born six weeks early, giving them a good chance of survival, but this could have been different if the Hansens decided to not go through with the surgery.

"Without the surgery I probably would have delivered between 24 and 28 weeks," Hansen said. "The surgery really prolonged everything, and gave them a better chance of coming without extra problems that often goes along with premature births."

Belfort explained that 24 weeks into the pregnancy is about the earliest doctors like to delivery a baby, but even then the baby has about a 50 percent chance of survival. At 28 weeks the chance of survival raises to 90 percent, with each week after adding a higher chance of survival. A normal pregnancy is about 40 weeks.

For more information about twin-to-twin transfusion syndrome, visit www.mfmutah.com.