You can claim an IVF tax deduction on your federal return as a medical expense, but only the portion of your total qualifying medical costs that exceeds 7.5% of your adjusted gross income, and only if you itemize on Schedule A instead of taking the standard deduction. The procedures also have to be performed on you, your spouse, or your dependent. That last condition is where most families get tripped up once egg donors or surrogates are involved.
Which IVF Costs Qualify
The clinical core of a cycle is the easiest part. Fertility clinic fees, embryology lab charges, egg retrieval, fertilization, and embryo transfer are deductible when the procedures are performed on you or your spouse.1Internal Revenue Service. Publication 502 – Medical and Dental Expenses – Section: Fertility Enhancement Anesthesia, monitoring ultrasounds, and the fees from reproductive endocrinologists and surgical staff during your cycle all count too.
Prescription medications are deductible, and fertility drugs are often the biggest single line item. Hormonal injections for ovarian stimulation, progesterone supplements, and other prescribed medications tied to the cycle all qualify. The drug has to be prescribed. General vitamins and fertility supplements do not count on Schedule A, even if a doctor recommended them.2Internal Revenue Service. Frequently Asked Questions About Medical Expenses Related to Nutrition, Wellness and General Health
Lab work and diagnostics connected to the cycle are eligible: bloodwork to monitor hormone levels, genetic testing of embryos, and imaging your clinic orders as part of the treatment plan. Mandatory counseling required by the clinic before treatment begins is also deductible.
Temporary storage of eggs, sperm, or embryos qualifies when it is part of your current treatment cycle. Publication 502 lists “temporary storage of eggs or sperm” specifically under fertility enhancement.1Internal Revenue Service. Publication 502 – Medical and Dental Expenses – Section: Fertility Enhancement Long-term storage purely for elective future use, with no connection to an active treatment plan, is a grayer area and has been denied in IRS private letter rulings.3Internal Revenue Service. Private Letter Ruling 202505002
Travel to the Clinic
If you drive to a fertility clinic, the IRS medical mileage rate for 2026 is 20.5 cents per mile.4Internal Revenue Service. IRS Sets 2026 Business Standard Mileage Rate at 72.5 Cents Per Mile, Up 2.5 Cents Lodging near the clinic is deductible up to $50 per night per person, and a companion traveling with you can claim the same amount, so a couple could deduct up to $100 per night.5Internal Revenue Service. Publication 502 – Medical and Dental Expenses – Section: Lodging Meals during medical travel do not qualify.
Donor and Surrogate Costs: The Rule That Trips People Up
The deduction only covers medical care for you, your spouse, or your dependent. When a procedure happens to someone else’s body, the cost is not your medical expense. The IRS has denied deductions for egg donor fees, donor egg retrieval, donor agency commissions, and every medical cost related to a gestational surrogate’s pregnancy, including embryo transfers into the surrogate, her prenatal care, delivery, and her insurance.6Internal Revenue Service. Private Letter Ruling 202114001
A more recent ruling extended that position, denying deductions for sperm freezing, embryo creation, and embryo storage where those steps were part of a surrogacy arrangement rather than treatment on the taxpayers themselves.3Internal Revenue Service. Private Letter Ruling 202505002 Surrogate compensation, agency fees, and legal fees for surrogacy contracts and parentage establishment are also outside the deduction.6Internal Revenue Service. Private Letter Ruling 202114001
What survives in a surrogacy arrangement is your own gamete production, like a sperm collection procedure performed on the taxpayer. Some fertility clinics tell patients that donor agency fees or donor legal costs are deductible. The IRS’s own rulings say otherwise, and its position is what governs an audit.
Other Costs That Don’t Count
- Vitamins, fertility supplements, and over-the-counter products, even if a doctor suggested them.
- Insurance premiums already paid with pre-tax dollars through your employer’s plan. Premiums paid with after-tax money can be included.
- Any portion of your IVF costs reimbursed by insurance. Subtract those amounts before you claim anything.
How the 7.5% AGI Floor Works
Once you have added up every qualifying expense, you can only deduct the amount that exceeds 7.5% of your adjusted gross income.7Internal Revenue Service. Topic No. 502, Medical and Dental Expenses Your AGI is on line 11 of Form 1040.8Internal Revenue Service. Adjusted Gross Income
An example. Your AGI is $120,000, and your total qualifying medical expenses for the year, including IVF, prescriptions, and other medical costs, come to $20,000. Multiply the AGI by 7.5%: $9,000. That is the floor. You can deduct the amount above it, which is $11,000.
If those same expenses totaled $8,000 instead, you would be below the $9,000 floor and could claim nothing. The threshold rewards concentrating medical spending into a single tax year when you have any flexibility over when bills get paid.
Does Itemizing Actually Beat the Standard Deduction?
The medical deduction only exists on Schedule A, so it only helps if your total itemized deductions beat the standard deduction. 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.9Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026
Add the medical amount above the 7.5% floor to your other itemizable deductions: mortgage interest, state and local taxes, and charitable contributions. If the total clears the standard deduction, itemize. If it does not, take the standard deduction and skip Schedule A. In a year with a full IVF cycle, families who normally take the standard deduction often find that itemizing wins. Run the comparison both ways before filing.
Which Tax Year the Expense Belongs To
Medical expenses are deductible in the year you pay them, not the year you receive the treatment.10Internal Revenue Service. Publication 502 – Medical and Dental Expenses A December clinic deposit for a January retrieval goes on the earlier year’s return. Credit card charges count in the year the charge is made, not when you pay off the balance.
One limit: you generally cannot prepay for care you will receive substantially beyond the end of the current year and deduct it now.11Internal Revenue Service. Publication 502 – Medical and Dental Expenses – Section: Payments for Future Medical Care Payments tied to services rendered or about to be rendered are fine. Since IVF cycles often straddle calendar years, when each bill was actually paid matters more than when the appointment happened.
HSA and FSA Money Instead
Health savings accounts and flexible spending accounts pay qualifying medical expenses with pre-tax dollars, which is a separate benefit that can work alongside the Schedule A deduction. For 2026, you can contribute up to $4,400 to an HSA with self-only coverage or $8,750 with family coverage under a high-deductible health plan.12Internal Revenue Service. Rev. Proc. 2025-19 – HSA Inflation Adjusted Items Health FSA contributions are capped at $3,400 for 2026. Your plan administrator may want a letter of medical necessity from the fertility clinic.
HSA and FSA rules are slightly more generous than Schedule A on one point: they can reimburse over-the-counter medicines and menstrual products without a prescription.13Internal Revenue Service. IRS Outlines Changes to Health Care Spending Available Under CARES Act On Schedule A, drugs still have to be prescribed.
You cannot claim the same dollar twice. Expenses reimbursed through an HSA or FSA cannot also appear as itemized deductions. A common approach is to run as much as possible through the HSA or FSA first, since those accounts avoid both income tax and payroll tax, then deduct any remaining unreimbursed expenses on Schedule A if you clear the 7.5% floor.
What to Keep
For each expense you claim, hold onto the itemized bill showing the provider, service, and date, along with proof of payment: credit card statements, bank records, or canceled checks. Keep every Explanation of Benefits from your insurer, since any amount they reimburse has to be subtracted from your claimed total.
Deductible expenses go on Schedule A of Form 1040. You enter your total qualifying expenses, subtract 7.5% of your AGI, and carry the result forward.7Internal Revenue Service. Topic No. 502, Medical and Dental Expenses Keep the records for at least three years from the date you file, the general statute of limitations for IRS audits.14Internal Revenue Service. How Long Should I Keep Records