Can You Claim Fertility Treatments on Taxes? Surrogacy and Schedule A

You can claim fertility treatments on taxes as a medical expense deduction. The IRS treats IVF, IUI, fertility medications, and related care as qualified medical expenses when they’re performed to overcome an inability to have children.¹ The catch is that the deduction only helps if you itemize on Schedule A and your total unreimbursed medical costs exceed 7.5% of your adjusted gross income.²

Which Fertility Expenses Qualify

The IRS lets you include the cost of procedures performed on you, your spouse, or your dependent to overcome an inability to have children.¹ That specific phrase matters. It ties the deduction to treating a reproductive condition rather than simply wanting to become a parent. Costs paid for your spouse’s treatment are deductible on a joint return the same as costs paid for your own.³

The following fertility-related costs qualify:

IVF and IUI procedures, including egg retrieval, embryo creation, and transfer.
Prescription fertility medications, including hormone injections and oral ovulation-stimulation drugs.
Reproductive surgeries to correct conditions such as blocked fallopian tubes, endometriosis, or varicocele, and surgery to reverse a prior sterilization.¹
Diagnostic testing performed as part of a fertility workup, including blood work, ultrasounds, and semen analysis.
Temporary egg and sperm storage fees connected to an IVF cycle or other fertility procedure.¹
Egg or sperm donor fees when the donation is part of a physician-supervised treatment plan.

Non-prescription supplements and vitamins don’t qualify, even when they’re marketed for fertility, and neither does any procedure performed for general wellness rather than to treat a diagnosed condition.³

Surrogacy Costs Are Not Deductible

Expenses related to a gestational carrier are not deductible. That includes the surrogate’s medical care, her health insurance premiums, legal fees for the surrogacy agreement, and her compensation. The IRS confirmed this in Letter Ruling 202518023, issued in February 2025.⁴

The reasoning comes straight from the statute: the medical expense deduction covers care provided to the taxpayer, a spouse, or a dependent, and a gestational carrier is none of those.² Even when surrogacy is medically necessary, the carrier’s expenses belong to the carrier for tax purposes.

You can still deduct your own IVF-related costs within a surrogacy arrangement. Egg retrieval, sperm collection, embryo creation, fertility medications, and screening performed on you or your spouse remain deductible.¹ The line falls along whose body the procedure treats.

When There’s No Diagnosed Fertility Condition

Because the deduction is tied to overcoming an inability to have children, the IRS has denied it when taxpayers cannot point to an underlying medical condition. In Letter Ruling 202114001, the IRS denied deductions for a same-sex couple’s egg retrieval, IVF, and surrogacy expenses on that basis. In Morrissey v. United States, the Eleventh Circuit ruled that being unable to reproduce as a couple is not itself a medical condition affecting either person’s body. In Magdalin v. Commissioner, the Tax Court reached the same conclusion for a single heterosexual man’s reproduction expenses.

If either you or your spouse has a diagnosed fertility condition, the treatments performed on that body remain deductible. Costs arising purely from needing a third party to reproduce, without an underlying diagnosis, generally do not.

Travel and Lodging for Treatment

Transportation for medical care is deductible. If you drive, the rate is 20.5 cents per mile for 2026, plus tolls and parking.⁵ Bus, train, taxi, and airfare are deductible at actual cost.³

Lodging while away from home for treatment is deductible up to $50 per night per person, and the accommodations cannot be lavish or extravagant. If someone needs to travel with you, common during IVF cycles where a partner is also undergoing procedures, that person’s lodging qualifies too, bringing the combined cap to $100 per night.¹

Meals during medical travel don’t qualify. Neither do gym memberships or wellness products, even if they support fertility indirectly.

The Two Thresholds That Decide Whether the Deduction Helps

Two separate financial bars stand between you and any actual tax savings.

The first is itemizing. You have to file Schedule A rather than take the standard deduction, and itemizing only makes sense when your combined itemized deductions exceed the standard deduction for your filing status. For 2026, the standard deduction is $16,100 for single filers, $32,200 for married couples filing jointly, and $24,150 for heads of household.⁶

The second is the 7.5% floor. Only medical expenses that exceed 7.5% of your adjusted gross income count.² At $100,000 AGI, the first $7,500 in medical expenses produces zero deduction. At $150,000 AGI, the floor rises to $11,250.

Fertility patients often clear the 7.5% floor in a way most taxpayers can’t. A single IVF cycle runs $15,000 to $30,000, and many patients need more than one. Total costs frequently exceed the threshold in the same calendar year the treatment happens.

Using an HSA or FSA Instead

If itemizing doesn’t work for you, a Health Savings Account or Flexible Spending Account offers a different route to a tax break. Both let you pay qualified medical expenses with pre-tax dollars, so you get the tax benefit without itemizing and without needing to clear the 7.5% AGI floor.

For 2026, the HSA contribution limit is $4,400 for self-only coverage and $8,750 for family coverage.⁷ You need a high-deductible health plan to contribute, but unused funds roll over, so a balance can build up before treatment starts. The FSA limit for 2026 is $3,400 per employee, and FSA funds generally must be spent within the plan year.

Eligible HSA and FSA expenses mirror what qualifies for the itemized deduction: IVF and IUI, fertility medications, diagnostic testing, storage tied to treatment, and donor fees. Surrogacy costs are excluded from HSA and FSA coverage for the same reason they’re excluded from Schedule A.

You can use both approaches in the same year, but you can’t count the same dollar twice. Any expense paid from an HSA or FSA is no longer an out-of-pocket cost and can’t also appear in your Schedule A calculation. Many families pay what they can from an HSA or FSA and then include remaining unreimbursed expenses in the itemized deduction.

Records to Keep

For every expense you plan to deduct or pay from an HSA or FSA, keep the itemized bill showing the date of service, the specific procedure, and the amount charged. Pair each bill with proof of payment: a bank statement, credit card record, or canceled check.

Separate what insurance covered from what you paid yourself. Only unreimbursed expenses qualify.² Hold on to the Explanation of Benefits statements from your insurer alongside your own payment records. If reimbursement arrives after you’ve filed, you may need to report it as income the following year.

For travel, keep a mileage log with dates and destinations if you drive, or receipts for public transportation and ride services. Lodging receipts should show the nightly rate to confirm the $50 per person limit. Keep supporting records for at least three years from the date you filed the return or the date it was due, whichever is later.⁸

How to File the Deduction on Schedule A

Total your unreimbursed medical expenses for the year, including fertility treatments, medications, travel, and lodging. Report the total on the medical expenses line of Schedule A, enter your AGI from Form 1040, and follow the form’s calculation of 7.5% of AGI. The amount above that floor is your deductible medical expense.

Add that figure to your other itemized deductions. If the combined total exceeds the standard deduction for your filing status, itemize. If it doesn’t, take the standard deduction and skip Schedule A. For a married couple filing jointly against a $32,200 standard deduction, the break-even point is high, which is why the HSA or FSA route works better for many families going through fertility treatment.⁶

1
Internal Revenue Service. Publication 502 – Medical and Dental Expenses
2
Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses
3
Internal Revenue Service. Topic No. 502, Medical and Dental Expenses
4
Internal Revenue Service. Letter Ruling 202518023
5
Internal Revenue Service. IRS Sets 2026 Business Standard Mileage Rate at 72.5 Cents Per Mile, Up 2.5 Cents
6
Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026
7
Internal Revenue Service. 2026 Inflation Adjusted Amounts for Health Savings Accounts
8
Internal Revenue Service. How Long Should I Keep Records