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.