Yes, I researched the different ART fertilisation methods and am aware of the differences between them.

My question is a more philosophical one.

It appears that my clinic basically goes directly from IUI to ICSI, with no apparent consideration of using (or advising the recipients of) IVF.

ICSI was originally a method of overcoming severe problems with male infertility (eg. Low sperm count, bad mobility, etc) though more recently it is also used to treat female infertility associated with "hard egg shells" (zona pellucida) as in the case of older ladies.

So why does it seem that clinics now use ICSI as the "standard procedure"?

One suggestion, as you also mentioned, is that clinics may use ICSI as a way to increase their success rates. Certainly IVF and ICSI have higher success rates than IUI, though IVF and ICSI success rates may not be that different (more on this in the next message).So, if the female recipient has no fertility problems and utilises donor sperm, then why does the clinic suggest ICSI and not IVF?

My next question is an ethical one (to provoke discussion). In the case of IUI or IVF, natural selection comes into play with (usually) the "best and fittest" sperm that fertilises the egg. However, with ICSI it is the case that the "luckiest" sperm is chosen by the lab technician to be injected into the egg for fertilisation. So with ICSI it is quite literally the lab technician who is selecting (albeit blindly) the outcome. So if the female recipient has no fertility problems and utilises donor sperm, then would it be better to utilise natural selection via IUI or IVF rather than ICSI, or is it acceptable for the outcome to be selected by a lab technician?

Lastly, do recipient couples who utilise ICSI ever research if the ICSI process affects the resulting offspring?

There are no right or wrong answers, just individual points of view. What is yours?