When Karen Smith first began trying to get pregnant, she was 23 years old and menopause was the last thing on her mind. "I figured I wouldn't have a problem because I was in my fertile prime," she said. After a few months of trying, Karen went to see her ob-gyn, who gave her a clean bill of health, even after Karen told him that ovulation predictor kits showed that she was ovulating every few months. "The doctor told me to just keep trying," she recalls. Finally, after three years of trying, Karen went to see a reproductive endocrinologist. The endocrinologist did some tests and found that Karen had the estrogen levels of a menopausal woman. "It turns out that infertility is often the only sign of early menopause. I didn't have hot flashes or any other symptoms; my estrogen was just extremely low," Karen says. Karen was given hormone injections and intrauterine insemination (IUI), but after three procedures, the physician told her that her only options for pregnancy were adoption or IVF with donor eggs. "I figured I wouldn't have a problem because I was in my fertile prime." "It was a really tough decision," Karen says today. "On the one hand, we could adopt. It might be difficult and take a long time, but at the end of the road we could be pretty sure of having a child. If we tried donor eggs and IVF, it might not work. And it costs so much money!" After a lot of soul searching, Karen decided that she wanted the experience of carrying and bearing a child, so she went ahead with IVF using donor eggs. She and her husband had to take out a loan to be able to afford it. She recalls, "I had to sit down and write a $23,000 check to the hospital." They were lucky because donated eggs became available relatively quickly. But the process was still daunting. "They want to make sure you understand that the whole thing might not work," Karen explains. "They reiterate that again and again, so the whole time, I was sure it wasn't going to happen. It wasn't until the day of the procedure that the doctor told me, 'This is going to work.' That was the first time I felt a little hopeful." After the procedure, Karen had to wait two weeks to have a pregnancy test. "We went home after the test and played video games, just waiting for the phone to ring," says Karen. "Finally, it rang, and the nurse said, 'Congratulations,' and I gave my husband the thumbs-up. We just couldn't believe it." Audrey was born at just 35 weeks, small but robust. After her birth, Karen didn't use birth control, convinced that she'd never get pregnant without intervention. But eight months after Audrey was born, Karen discovered she was pregnant again. "I was shocked, amazed, and happy," she says. "My reproductive endocrinologist told us that a pregnancy will sometimes reset your system and normalize your hormones. That seems to be what happened to me." Karen advises women who are going through infertility to try to avoid making pregnancy their entire focus. "If you can, find something else to concentrate on," she says. "You need to have another hobby or interest besides getting pregnant. I should have followed that advice, but it was all I could think about and it was terrible -- it took over our lives." As for what surprises her the most about motherhood, Karen says, "You just don't realize how fun it will be and how much you'll laugh