IVF is expensive. The average out-of-pocket cost for a single cycle runs $12,000–$25,000, and most patients require more than one. But the tax code offers meaningful relief — if you know how to use it.
This guide explains every tax-saving strategy available for fertility treatment costs in 2025: the federal medical expense deduction, what qualifies under IRS Publication 502, HSA and FSA accounts, state-level IVF tax credits, and a sample savings calculation to show you what you could actually save.
Important disclaimer: Tax law is complex and individual circumstances vary. Always consult a qualified tax professional (CPA or enrolled agent) before making decisions based on this guide. The IRS rules on some fertility-related expenses — particularly third-party reproduction — are not always clear, and professional guidance is valuable.
The Federal Medical Expense Deduction (Schedule A)
The most broadly applicable tax benefit for fertility patients is the medical expense deduction available to taxpayers who itemize deductions on Schedule A of their federal tax return.
How It Works
You can deduct medical expenses that exceed 7.5% of your Adjusted Gross Income (AGI). Only the amount above that threshold is deductible.
Example:
- AGI: $90,000
- 7.5% threshold: $6,750
- Total medical expenses: $22,000
- Deductible amount: $22,000 - $6,750 = $15,250
If you're in the 22% federal tax bracket, deducting $15,250 saves you approximately $3,355 in federal taxes.
The Itemization Requirement
To claim the medical expense deduction, you must itemize deductions on Schedule A rather than taking the standard deduction. For 2025, the standard deduction is:
- $15,000 for single filers
- $30,000 for married filing jointly
You should itemize only if your total itemized deductions (medical expenses above threshold + mortgage interest + state/local taxes + charitable contributions) exceed the standard deduction. For most taxpayers, the medical expense deduction only creates tax savings in years with very high medical costs.
Strategy: If you're pursuing IVF, consider timing deductible expenses so they cluster in a single tax year to maximize the deduction. This may mean delaying or accelerating certain payments.
Reducing Fertility Costs at Home
Before incurring large deductible IVF expenses, many fertility patients explore lower-cost options.
For many individuals and couples, at-home insemination is a practical first step that costs far less than clinical treatment. MakeAMom offers reusable home insemination kits — including the CryoBaby, Impregnator, and BabyMaker — designed for a range of sperm and sensitivity situations.
Explore home insemination kits at MakeAMom →
What Fertility Costs Qualify as Medical Expenses (IRS Publication 502)
IRS Publication 502 defines qualifying medical expenses as costs paid for the "diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body."
Expenses That Clearly Qualify
Based on IRS Publication 502 and related IRS guidance, the following fertility-related expenses are generally deductible:
- IVF procedures: Egg retrieval, fertilization, embryo transfer, and related clinic fees
- Fertility medications: Gonadotropins, GnRH agonists/antagonists, progesterone supplements, and other prescribed fertility drugs
- Diagnostic testing: Bloodwork, ultrasounds, semen analysis, genetic testing ordered as part of diagnosis or treatment
- Fertility monitoring: Office visits and monitoring appointments
- Intrauterine insemination (IUI): The procedure and associated costs
- Sperm storage: When sperm is stored for use in a fertility treatment (medical necessity context)
- Embryo storage fees: Cryopreservation and annual storage costs when associated with a treatment plan
- Fertility specialist fees: Consultation fees, reproductive endocrinologist visits
Expenses With More Complexity
The following expenses may qualify but require careful documentation or professional guidance:
Donor egg costs: The IRS has not issued comprehensive guidance on donor egg expenses. The medical costs incurred by the egg donor (her medications, monitoring, retrieval) are generally deductible for the recipient couple. However, the fee paid to the donor herself is more ambiguous.
Donor sperm: The cost of donor sperm used in a medically supervised procedure is generally considered a deductible medical expense.
Gestational surrogacy: Surrogacy costs are among the most legally uncertain fertility expenses in the tax code. Some components — such as medical procedures performed on the surrogate — are arguably not deductible by the intended parents because the expenses are not for the taxpayer's own body. Other components may qualify. Consult a tax attorney experienced in reproductive law.
Fertility preservation (egg freezing): Egg freezing for medical necessity (e.g., before chemotherapy) is generally deductible. Elective egg freezing purely for social reasons is more ambiguous, though many tax professionals argue it qualifies as medical care.
Travel expenses: If you travel to a fertility clinic for treatment, you can deduct transportation costs (car mileage at the medical rate, airfare, lodging) if the primary purpose is medical care. The 2025 medical mileage rate is 21 cents per mile.
Expenses That Do Not Qualify
- Gym memberships or nutrition programs unless specifically prescribed by a physician for a defined medical condition
- Surrogacy agency fees (legal/administrative rather than medical in nature)
- Adoption expenses (a separate adoption tax credit applies — see below)
- Life insurance premiums or health insurance premiums paid pre-tax by an employer
Adoption Tax Credit
If you pursue adoption, a separate federal adoption tax credit is available. For 2025, the maximum credit is $16,810 per adopted child. Note: this is a credit (dollar-for-dollar tax reduction), not a deduction, making it more valuable than a deduction of equivalent size.
The adoption tax credit applies to qualified adoption expenses including adoption agency fees, attorney fees, court costs, and travel. Income phase-outs apply at higher AGI levels.
HSA and FSA Tax Savings for Fertility Treatment
Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) allow you to pay for qualifying medical expenses with pre-tax dollars. This effectively reduces your cost by your marginal tax rate without requiring you to itemize or exceed the AGI threshold.
How HSA/FSA Tax Savings Work
If you're in the 22% federal tax bracket plus your state income tax rate (say, 5%), using an HSA or FSA saves you approximately 27 cents for every dollar spent on qualifying fertility expenses. On a $20,000 IVF cycle, that's $5,400 in effective savings.
2025 Contribution Limits
| Account Type | Individual Limit | Family Limit |
|---|---|---|
| HSA (requires HDHP) | $4,300 | $8,550 |
| FSA (employer plan) | $3,300 | $3,300 |
| Dependent Care FSA | $5,000 (family) | $5,000 |
Using Your HSA Strategically
HSAs have no "use it or lose it" requirement — funds roll over indefinitely. This makes HSAs excellent for fertility treatment:
- Contribute the maximum in the year(s) before and during IVF treatment
- Invest HSA funds in low-fee index funds while you accumulate (many HSA providers allow this after a minimum balance is reached)
- Pay out of pocket and reimburse yourself later — you don't have to reimburse yourself in the same year, allowing your HSA to grow tax-free
This "HSA stacking" strategy can significantly increase the purchasing power of your HSA contributions over time.
FSA Considerations for IVF
FSAs have a $3,300 annual limit and are "use it or lose it" (though many plans allow a $660 rollover or a 2.5-month grace period). For a single IVF cycle, the FSA is best used for predictable expenses: medications, monitoring visits, or a portion of the retrieval fee you're certain will occur before year-end.
State-Level IVF Tax Credits (2025)
In addition to the federal deduction, a small but growing number of states offer their own tax incentives for fertility treatment:
New York
New York does not have a dedicated IVF tax credit, but New York's medical expense deduction generally follows federal rules, allowing itemizing taxpayers to deduct qualifying fertility expenses at the state level.
Minnesota
Minnesota has introduced legislation proposing an IVF tax credit, though as of early 2025 it had not been enacted. Monitor the Minnesota Department of Revenue website for updates.
Missouri
Missouri has introduced bills proposing a fertility treatment tax credit for state residents. Status as of 2025: pending legislative action.
Federal Legislative Efforts
Several federal bills have been introduced that would create a federal IVF tax credit (distinct from the deduction), including the Family Act, which would create a 20%–25% credit for IVF expenses up to a specified cap. As of early 2025, these bills had not been enacted.
Monitor: RESOLVE's legislative tracker provides current status of state and federal fertility tax legislation.
Sample Tax Savings Calculation
The following table illustrates potential tax savings for a married couple filing jointly with a $130,000 combined AGI who spend $25,000 on IVF in a single tax year.
| Scenario | Amount |
|---|---|
| Combined AGI | $130,000 |
| 7.5% AGI threshold | $9,750 |
| Total medical expenses (IVF + other) | $27,000 |
| Deductible medical expenses | $17,250 |
| Federal tax bracket | 22% |
| Federal tax savings from deduction | $3,795 |
| State tax rate (example: 5%) | 5% |
| State tax savings | $863 |
| HSA contributions used (pre-tax) | $8,550 |
| Tax savings on HSA at 27% combined rate | $2,309 |
| Total estimated tax benefit | $6,967 |
This example illustrates that a well-planned tax strategy can reduce the effective cost of IVF by several thousand dollars, though results vary based on individual circumstances.
Documentation Required
To claim fertility-related deductions, maintain organized records throughout your treatment:
What to Keep
- Explanation of Benefits (EOBs) from your insurer for any partially covered services
- Itemized receipts or invoices from your fertility clinic for each service
- Pharmacy receipts for all fertility medications
- Bank or credit card statements showing payment dates
- A mileage log if you're deducting travel to medical appointments
- Written treatment plan or prescription from your physician connecting expenses to medical treatment
How Long to Keep Records
The IRS generally has 3 years from the filing date to audit a return, but can go back 6 years if there is a substantial understatement of income. Keep fertility tax records for at least 7 years.
Common Mistakes to Avoid
Mistake 1: Not checking whether itemizing beats the standard deduction. Many patients assume they can deduct IVF expenses without realizing they'd need to itemize and that their total itemized deductions must exceed the standard deduction.
Mistake 2: Forgetting about HSA/FSA savings. Even if you can't itemize, using an HSA or FSA for fertility expenses provides immediate pre-tax savings.
Mistake 3: Not clustering expenses. If you're spreading IVF costs across two tax years, you may fall short of the 7.5% threshold in both years rather than exceeding it in one. Consider timing payments strategically.
Mistake 4: Claiming expenses paid by your insurance. Only unreimbursed out-of-pocket expenses are deductible. Expenses covered by insurance don't qualify.
Mistake 5: Omitting travel costs. Many patients forget that mileage, parking, and lodging for medical appointments are deductible when the primary purpose is medical care.
Working With a Tax Professional
Given the complexity of fertility-related tax rules — especially for third-party reproduction and surrogacy — working with a CPA or enrolled agent who has experience with medical expenses or reproductive health issues is worthwhile.
Questions to ask your tax professional:
- Based on my AGI and anticipated medical expenses, should I itemize this year?
- How should I document donor egg or sperm expenses?
- Is my FSA or HSA being used optimally for fertility expenses?
- Do any state tax credits apply in my state?
For a complete picture of what IVF costs before tax savings, see our IVF Cost Breakdown for 2025 and IVF Financing Options guides.
This article is for informational purposes only and does not constitute tax or legal advice. Tax laws change frequently. Consult a qualified tax professional for advice specific to your situation.
