The IRS has confirmed in multiple rulings that fertility treatments qualify as medical expenses. This includes IVF cycles, egg retrieval, embryo transfer, cryopreservation, and related medications. Surrogacy costs for the surrogate's medical expenses may also qualify.
Pro Tip: Use an HSA or FSA to pay for fertility treatments with pre-tax dollars -- this is often more valuable than the itemized deduction. If your employer offers a fertility benefit, maximize that first.
Qualifying fertility expenses include: IVF cycles (egg retrieval, fertilization, embryo transfer), egg freezing and storage, sperm analysis and banking, fertility medications, intrauterine insemination (IUI), genetic testing of embryos (PGT), and fertility specialist consultations. Travel to fertility clinics may also qualify.
You can only deduct medical expenses -- including fertility costs -- that exceed 7.5% of your AGI. If your AGI is $120,000, you must spend more than $9,000 on qualifying medical expenses before any deduction kicks in. Fertility treatments often exceed this threshold in a single cycle.
Paying fertility costs with an HSA or FSA is almost always better than the itemized deduction. HSA/FSA funds are pre-tax, so you save at your marginal rate on every dollar -- with no 7.5% floor. Maximize these accounts before relying on the itemized deduction.
Here is how this deduction typically works in real situations:
A couple with $150,000 AGI spends $30,000 on IVF. Their total medical expenses are $35,000.
A self-employed individual with a high-deductible health plan contributes $8,300 to their HSA and uses it to pay for egg freezing and fertility medications.
An employee uses $3,050 from a Healthcare FSA for fertility drugs, then deducts remaining $20,000 in IVF costs on Schedule A.
Key Takeaway: The difference between a valid deduction and a denied one usually comes down to documentation, usage percentage, and proper structuring. The same expense can be fully deductible, partially deductible, or not deductible at all — depending on how it is handled.
Yes. IVF, egg freezing, fertility medications, embryo storage, and related fertility treatments are deductible as medical expenses on Schedule A. You can deduct the amount exceeding 7.5% of your adjusted gross income. Using an HSA or FSA to pay for these costs provides an even better tax benefit.
Yes. The IRS has ruled that fertility treatments for same-sex couples qualify as deductible medical expenses. This includes costs for a non-biological parent when the treatment is necessary to have a child.
Yes. Egg freezing for medical reasons (fertility preservation before cancer treatment, for example) is clearly deductible. Elective egg freezing for social reasons is also generally considered deductible as a medical expense, though this area has less direct IRS guidance.
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