If you go through a few rounds of simple medicated cycles and you are still not pregnant, your doctor may recommend a cycle of in vitro fertilization (IVF) for diagnostic purposes. This can sometimes give the doctor insight into what’s going on: no eggs are retrieved from the ovarian follicles, the eggs may not properly fertilize, or the resulting embryos may not divide or grow. There would be no other way to observe these abnormalities, except through IVF.
Again though, sometimes even a diagnostic IVF cycle may not reveal any additional information. More advanced technologies will become necessary in these severe cases.
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Reference:
Galan, N. (2011). The everything fertility book. Avon, MA: Adams Media.