Most couples who are trying to conceive without success 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 (low egg supply) or for severe sperm problems needing ICSI. See a Reproductive Endocrinology and Infertility (REI) specialist for testing and for treatment options.