(CNN) -- Pamela Madsen knows a thing or two about getting pregnant. She did it twice, and it took several teams of doctors, six rounds of artificial insemination, six rounds of daily injected drugs, and four rounds of in-vitro fertilization.

Pamela Madsen had four rounds of in-vitro fertilization before her sons Spencer, left, and Tyler, were conceived.

She's madly in love with the results -- son Tyler is 19 and Spencer is 15 -- but she didn't always love the process. That's why she started the American Fertility Association -- to help other couples in the same position.

"Getting pregnant isn't always an easy thing to do," said Madsen. "Doctors are not gods, and you have to remember that no one's going to care about you as much as you are."

Here are a few things Madsen said she did right while going through infertility treatments.

1. Get Dad out of the hot tub

Couples often forget that 40 percent of infertility is due to something wrong with the man, according to Sheryl Kingsberg, chief of the division of behavioral medicine at Case Western Reserve University School of Medicine.

That means Dad has to watch what he does. Hot tubs are one example.

"Sitting in a 103-degree tub for prolonged periods of time may impair sperm quality," said Dr. Alan Copperman, with Reproductive Medicine Associates in New York.

Being obese, smoking, drinking heavily, or using illegal drugs also can affect sperm count. Women need to follow the same advice, because all of these can affect her fertility, too, Copperman added.

2. Use an ovulation predictor kit

This isn't necessary, but it might speed a referral to a fertility specialist, according to Madsen.

"When you go to the doctor and you say you're having trouble getting pregnant, they might tell you to just keep trying," she said. "But if you've been using an ovulation kit, you can prove to the doctor you've been trying at the right time of the month."

How long you should wait depends on your age and your health history. Fertility experts say if you're under 35, try for a year before proceeding with fertility treatments. If you've had certain problems -- endometriosis, for example, or irregular periods -- don't wait that long, said Dr. Andrew Toledo with Reproductive Biology Associates in Atlanta, Georgia.

Women over the age of 35 should wait no longer than six months before getting help, experts said.

"There's definitely a need to be proactive, but not panicky," Toledo said.

Health Library MayoClinic.com: Infertility

3. Go to a clinic that's open seven days a week

When it comes to procedures such as harvesting eggs and implanting embryos, one day can make a difference," Madsen said. "If they're not open seven days a week, they're manipulating your cycle to fit their schedule."

For help finding a fertility clinic, check success rate statistics at the Centers for Disease Control and Prevention and the Society for Assisted Reproductive Technology. Also, ask these questions suggested by the American Society for Reproductive Medicine.

4. Get a "cycle buddy" -- real or virtual

Madsen said one of the smartest things she did while trying to get pregnant was to strike up a conversation with another would-be mom over the coffee maker in her doctor's waiting room.

"It turned out she was on the same cycle I was, and we became 'cycle buddies,' " she said. "I'd talk to her for hours about the size of my follicles and the fluffiness of the lining of my uterus. Believe me, no one else, including your husband, wants to talk endlessly about those details."

If you're too shy to accost another patient in the waiting room, find one on discussion forums at fertility groups such as Resolve, Inciid and the American Fertility Association.

5. Get a second opinion

"If you feel like your doctor isn't paying attention to your case, or you feel like you're just a number, or you're not having success after several cycles, it's really OK to ask for a second opinion," Madsen said. "And if your doctor isn't OK with that, that's reason enough for you not to be there."

In the midst of all this, don't think you're nuts if you start to feel little bit crazy, Kingsberg advised.



"The psychological impact of infertility cannot be overstated," Kingsberg said. "Your sexual lives are now open for scrutiny, your financial lives may be in jeopardy, the time commitment tends to interfere with work."

Madsen agreed, and said couples should control what they can. For example, early on, she asked nurses to call her husband with the results of pregnancy tests.

"I felt like I could handle it better hearing the news from my husband," she said. "We had six 'failure' phone calls, and then one day my husband delivered flowers to my work that said "All my love to the both of you."

CNN's Jennifer Pifer contributed to this report.