Can You Deduct IVF Expenses on Your Taxes? AGI Floor and HSAs

You can deduct IVF expenses on your taxes as medical expenses, but only the portion of your qualifying costs that exceeds 7.5% of your adjusted gross income, and only if you itemize on Schedule A instead of taking the standard deduction. Because a single IVF cycle commonly runs $15,000 to $30,000 before medications, many families clear that threshold in the year they go through treatment. What ultimately qualifies depends on which specific costs you paid, who the procedures were performed on, and whether your itemized total beats the standard deduction for your filing status.

Which IVF Costs Qualify

IRS Publication 502 states that you can include in medical expenses the cost of procedures like in vitro fertilization performed on yourself, your spouse, or your dependent to overcome an inability to have children.¹ That covers the core clinical charges of a cycle: fertility clinic fees, embryology lab work, egg retrieval, fertilization, embryo transfer, anesthesia, monitoring ultrasounds, and the fees of your reproductive endocrinologist and surgical team.

Prescription fertility medications count, and they are often one of the largest line items. Hormonal injections for ovarian stimulation, progesterone supplements, and other prescribed drugs related to the cycle all qualify. The drug has to be prescribed; general vitamins and supplements do not count toward the Schedule A deduction even if your doctor recommended them.²

Diagnostic and lab work tied to your cycle is eligible too. That includes bloodwork to track hormone levels, preimplantation genetic testing of embryos, and imaging ordered as part of your treatment plan. Mandatory counseling sessions your clinic requires before beginning treatment also qualify.

Temporary storage of eggs, sperm, or embryos is deductible when it’s part of your current treatment.¹ Long-term storage solely for elective future use, without connection to an active treatment plan, is grayer and has been denied in IRS private letter rulings.³ If storage is required because chemotherapy or another medical condition demands it, the medical necessity strengthens the claim.

Travel to the Clinic

Many patients travel for fertility care, and those costs are deductible when the trip is primarily for medical care. For 2026, the IRS medical mileage rate is 20.5 cents per mile.⁴ Lodging near the clinic is deductible up to $50 per night per person, so a couple traveling together can claim up to $100 per night.⁵ Meals during medical travel are not deductible.

Donor and Surrogate Costs Generally Don’t Qualify

The IRS has drawn a hard line here, and it’s where most IVF deduction claims unravel. Medical procedures performed on someone who isn’t you, your spouse, or your dependent are not your deductible medical expense. The IRS has denied deductions for egg donor fees, donor egg retrieval, donor agency commissions, and all medical costs tied to a gestational surrogate’s pregnancy, including embryo transfers into the surrogate, her prenatal care, delivery, and her insurance.⁶ A more recent ruling extended that reasoning to deny deductions for sperm freezing, embryo creation, and embryo storage when those steps were part of a surrogacy arrangement rather than treatment performed on the taxpayers themselves.³

What this means in practice depends on your situation. If you’re the one undergoing retrieval, fertilization, and transfer, those clinical costs are deductible because they’re performed on your body. If you’re using donor eggs and a gestational surrogate, almost none of the major clinical costs qualify. The expense the IRS has consistently allowed in surrogacy arrangements is the intended parent’s own gamete production, such as a sperm collection procedure performed on the taxpayer.

Legal fees for surrogacy contracts and parentage establishment are also not deductible.⁶ Some fertility clinic materials suggest donor agency fees and donor legal fees are deductible. The IRS rulings say otherwise, and the IRS position is what controls on audit.

Other Costs That Don’t Qualify

Surrogate compensation. Base pay, pain and suffering reimbursements, and other payments to a gestational carrier are not medical care for the taxpayer.
Non-prescription supplements. Vitamins, fertility supplements, and over-the-counter products do not qualify for Schedule A even if a doctor suggested them. Only prescribed drugs and insulin count.⁷
Insurance premiums paid pre-tax. If your employer-sponsored plan covers part of IVF and premiums come out of your paycheck before taxes, they’re already tax-advantaged and can’t be claimed again. Premiums you pay with after-tax dollars can be included.
Reimbursed amounts. Any portion of your IVF costs covered by insurance has to be subtracted from your total before calculating the deduction.

How the 7.5% AGI Floor Works

Even after you’ve added up every qualifying expense, you can only deduct the amount that exceeds 7.5% of your adjusted gross income.⁸ AGI appears on line 11 of Form 1040.⁹ The floor applies to all taxpayers regardless of age.

Here’s the math. Say 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 your AGI by 7.5% to get the floor: $9,000. You can deduct the amount above the floor, which is $11,000.

If those qualifying expenses had totaled $8,000 instead, you’d be below the $9,000 floor and couldn’t claim any medical deduction at all. The threshold rewards concentrating expenses into a single tax year when you have any control over timing.

Does Itemizing Actually Help You?

The medical expense deduction only reaches taxpayers who itemize on Schedule A.² 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.¹⁰ Itemizing only pays off if your total itemized deductions, which include the medical amount above the 7.5% floor plus mortgage interest, state and local taxes, and charitable contributions, exceed the standard deduction for your filing status.

In a year with a major IVF cycle, families who normally take the standard deduction often find itemizing wins. Run the comparison both ways before you file. Once your itemized total crosses the standard deduction, every additional qualifying dollar is directly reducing taxable income.

Which Tax Year to Claim

Medical expenses are deductible in the year you paid them, not the year you received the treatment.² A clinic deposit paid in December 2026 for a January 2027 retrieval goes on your 2026 return. Charges placed on a credit card count in the year the charge is made, not when you pay off the balance.

One restriction: you generally can’t prepay for medical care you’ll receive substantially beyond the end of the current year and deduct it now.¹¹ A large advance payment for next year’s cycle could be disallowed. Payments tied to services already rendered or about to be rendered are fine.

Because IVF cycles often cross calendar years, tracking when each bill was actually paid matters more than when the appointment happened. Shifting a payment by a few weeks to concentrate expenses in the higher-deduction year is legitimate planning.

HSA and FSA as a Parallel Route

Health savings accounts and flexible spending accounts give you a separate tax advantage that works alongside the Schedule A deduction. Both let you pay qualifying medical expenses with pre-tax dollars, which effectively discounts them by your marginal tax rate.

For 2026, HSA contributions are capped at $4,400 with self-only coverage or $8,750 with family coverage under a high-deductible health plan.¹² Health FSA contributions are capped at $3,400. IVF expenses paid from either account have to be for qualifying medical care, and your plan administrator may want a letter of medical necessity from your clinic.

One difference matters: HSA and FSA accounts can reimburse over-the-counter medicines and menstrual care products without a prescription under changes made by the CARES Act. That expanded eligibility applies only to HSA and FSA spending, not to Schedule A, where drugs still have to be prescribed.¹³

You can’t claim the same expense twice. Costs reimbursed through an HSA or FSA can’t also appear as itemized deductions on Schedule A. For many families the better order 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.

Records to Keep

Fertility care generates a lot of paper. For each expense you claim, keep the itemized bill showing the provider, service description, and date, along with proof of payment. Credit card statements, bank records, and canceled checks all work.

If insurance covered any part of your treatment, hold onto every Explanation of Benefits. These confirm what was covered and what remained your responsibility, and any reimbursed amount has to be subtracted from your claimed total.

Report deductible medical expenses on Schedule A of Form 1040. Enter total qualifying expenses, subtract 7.5% of your AGI, and carry the result to the appropriate line.⁸ Keep records for at least three years from the date you file, which is the general statute of limitations for IRS audits.¹⁴

1
Internal Revenue Service. Publication 502 – Medical and Dental Expenses – Section: Fertility Enhancement
2
Internal Revenue Service. Publication 502 – Medical and Dental Expenses
3
Internal Revenue Service. Private Letter Ruling 202505002
4
Internal Revenue Service. IRS Sets 2026 Business Standard Mileage Rate at 72.5 Cents Per Mile, Up 2.5 Cents
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Internal Revenue Service. Publication 502 – Medical and Dental Expenses – Section: Lodging
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Internal Revenue Service. Private Letter Ruling 202114001
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Internal Revenue Service. Frequently Asked Questions About Medical Expenses Related to Nutrition, Wellness and General Health
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Internal Revenue Service. Topic No. 502, Medical and Dental Expenses
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Internal Revenue Service. Adjusted Gross Income
10
Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026
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Internal Revenue Service. Publication 502 – Medical and Dental Expenses – Section: Payments for Future Medical Care
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Internal Revenue Service. Rev. Proc. 2025-19 – HSA Inflation Adjusted Items
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Internal Revenue Service. IRS Outlines Changes to Health Care Spending Available Under CARES Act
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Internal Revenue Service. How Long Should I Keep Records