Is invitro the only option for couples who cannot conceive on their own?

Not the only option: Most couples who are ttc don't need in vitro fertilization (ivf) or icsi (intracytoplasmic sperm injection) - if cheaper and easier treatment is appropriate we try other things first. Sometimes ivf is the right answer: if inseminations aren't working, for severe disease of the fallopian tubes or diminished ovarian reserve, or severe sperm problems needing icsi. See rei specialist for options.