IVF costs may be deductible as medical expenses, but only if your total medical spending exceeds a threshold set by the IRS each year

You can deduct fertility treatment costs, including IVF, on your federal tax return — but only as part of your overall medical expenses, and only if those expenses add up to more than 7.5% of your adjusted gross income (AGI) for the tax year. The IRS treats IVF the same way it treats other medical care: as a deductible expense if you itemize deductions instead of taking the standard deduction.

For example, if your AGI is $100,000, you can only deduct medical expenses that exceed $7,500. If your total medical spending for the year — including IVF, doctor visits, prescriptions, and other healthcare costs — comes to $12,000, you can deduct $4,500 of it. If your medical expenses total less than $7,500, you cannot deduct any of them.

The threshold changes slightly each year. Check the IRS website or your tax software for the current year's percentage before you file.

Key Takeaways

  • IVF and fertility treatments count as medical expenses on your tax return, but only if your total medical spending exceeds 7.5% of your adjusted gross income.
  • You must itemize deductions on Schedule A to claim medical expenses; the standard deduction does not include them.
  • Deductible fertility costs include IVF procedures, medications, lab work, and some travel and lodging if required for treatment at a distant clinic.
  • Expenses paid through a health savings account (HSA) or flexible spending account (FSA) reduce your taxable income before the 7.5% threshold applies.
  • State taxes may allow different deductions than federal tax, so check your state's rules separately.

What fertility costs count as deductible medical expenses

The IRS allows you to deduct the direct cost of IVF procedures, including egg retrieval, fertilization, and embryo transfer. You can also deduct the cost of fertility drugs prescribed as part of your treatment cycle, lab work and diagnostic testing related to fertility, and consultations with reproductive endocrinologists or other fertility specialists.

Some less obvious costs also may have access to. If your fertility clinic is far from your home and you must travel for treatment, you can deduct lodging costs while you are there for the procedure. You can deduct mileage or airfare to reach the clinic, though you cannot deduct meals. If you need a surrogate or egg donor, the medical costs they incur as part of your treatment — not their compensation — are deductible.

Costs that do not count include surrogacy fees or egg donor compensation (the payment to the person, as opposed to their medical care), adoption fees, or any treatment not medically necessary. Cosmetic procedures are never deductible, even if they are performed at a fertility clinic.

Itemizing versus the standard deduction

To claim medical expenses, you must itemize deductions on Schedule A of your tax return instead of taking the standard deduction. For the 2024 tax year, the standard deduction is $14,600 for single filers and $29,200 for married couples filing jointly. If your itemized deductions (medical expenses plus mortgage interest, state and local taxes, charitable donations, and other allowed items) add up to more than the standard deduction, itemizing saves you money.

Many people with high medical expenses find that itemizing makes sense. If you are paying for IVF out of pocket, your medical expenses are likely substantial enough to push you over the standard deduction threshold, especially if you also have other medical costs like insurance premiums, dental work, or prescription medications.

Use the IRS Form 1040 instructions or tax software to calculate whether itemizing or taking the standard deduction gives you a larger deduction. You cannot do both in the same year.

Using an HSA or FSA to reduce the tax burden

A health savings account (HSA) or flexible spending account (FSA) can lower your tax bill on fertility costs before you even file your return. Money you contribute to an HSA or FSA is deducted from your gross income, which means it reduces the income on which you owe tax.

If you have an HSA through a high-deductible health plan, you can set aside up to $4,150 per year (for individual coverage in 2024) to pay for medical expenses, including IVF. If you have an FSA through your employer, the limit is usually $3,300 per year. You pay no federal income tax, Social Security tax, or Medicare tax on this money.

The catch: FSA money must be used in the same calendar year or you lose it (with a small carryover allowed in some plans). HSA money rolls over year to year, so it is more flexible if you are planning treatment across multiple years. Check your plan documents to confirm what fertility costs your HSA or FSA covers, because some plans exclude certain treatments.

State tax deductions for fertility treatment

Some states offer their own deductions or credits for fertility treatment costs, separate from the federal deduction. A few states, including New York and Illinois, have passed laws requiring insurance coverage of IVF, which can reduce your out-of-pocket costs and therefore your deductible expenses. Other states offer tax credits or deductions specifically for fertility treatment.

Your state's rules may be more generous than federal rules, or they may be stricter. For example, some states allow a deduction even if your medical expenses do not exceed the 7.5% threshold. Contact your state tax authority or a tax professional in your state to learn what you can deduct on your state return.

If you live in one state but received treatment in another, you may owe taxes in both states. The rules for which state gets to tax your income depend on where you lived and where the treatment took place. A tax professional familiar with your situation can help you sort this out.

Keeping records for your tax return

The IRS does not require you to submit receipts with your tax return, but you must keep them in case you are audited. Save every invoice from your fertility clinic, including itemized bills that show what each charge was for. Keep receipts for fertility medications, lab work, and any travel expenses you claim.

If you paid through an HSA or FSA, your account statements show what you spent and when. Keep those statements along with the original receipts. If you claimed mileage to the clinic, write down the dates and distances in a log.

The IRS can audit a return for up to three years after you file it, and longer if there is a substantial underreporting of income. Keeping organized records makes it straightforward to prove your deductions if you are selected for an audit.

When medical expenses span two tax years

If you start IVF treatment in one year and complete it in the next, you can only deduct the expenses in the year you paid them. If you paid for your first cycle in December 2024 and your second cycle in January 2025, the December expenses count toward your 2024 deduction and the January expenses count toward your 2025 deduction.

This timing matters because your income, other medical expenses, and the 7.5% threshold may be different in each year. You might not be able to deduct expenses in one year but be able to deduct them in another. If you are planning multiple cycles, talk to a tax professional about whether it makes sense to bunch expenses into a single year if possible.

Frequently Asked Questions

Can I deduct IVF if I use insurance to pay for part of it?

Yes. You can only deduct the amount you paid out of pocket, not the amount your insurance covered. If your insurance paid $5,000 and you paid $15,000, you can deduct the $15,000 (subject to the 7.5% threshold). Insurance premiums themselves are deductible as medical expenses too.

What if my employer paid for my fertility treatment?

If your employer paid the cost directly, you cannot deduct it because you did not pay it. However, if your employer offers an FSA or HSA, you can contribute your own money to those accounts and use it for fertility costs. Some employers also offer fertility treatment as a covered benefit, which means the cost is already tax-advantaged.

Can I deduct the cost of genetic testing of embryos?

Yes, if the testing is medically necessary to diagnose or treat a condition. Preimplantation genetic testing (PGT) for medical reasons is deductible. Testing done purely for family planning purposes (like sex selection) may not be, depending on how the IRS interprets your situation. A tax professional can advise you on your specific case.

Do I have to report my fertility expenses to my insurance company?

No. Your tax deduction is separate from your insurance claim. You can deduct out-of-pocket costs on your taxes regardless of whether you also filed a claim with your insurance company. If your insurance reimburses you after you file your taxes, you may need to adjust your deduction in a later year.

What if my fertility treatment was not successful?

You can still deduct the costs. The IRS does not require that medical treatment be successful to be deductible. If you paid for IVF that did not result in pregnancy, the full cost of the procedure, medications, and related expenses still counts as a medical expense.