Is IVF tax deductible? HSA, FSA, and the medical deduction (2026)
Yes, with conditions. IRS Publication 502 lists fertility enhancement — including IVF and temporary storage of eggs or sperm — as a deductible medical expense. Two things decide whether that is worth anything to you: whether you itemize, and the 7% of adjusted gross income floor.
Deductible
- IVF procedures, monitoring, retrieval, transfer
- Fertility medications (prescription)
- Temporary storage of eggs, sperm, or embryos
- Diagnostic testing
- Mileage and parking for treatment visits
- IUI
Not deductible
- Surrogacy costs (reaffirmed by IRS PLR 202518023, released May 2, 2025)
- Costs reimbursed by insurance, HSA, FSA, or a carve-out vendor
- Expenses paid in a different tax year than claimed
Gray areas — get a medical-necessity letter
- Extended (multi-year) storage
- Elective egg freezing without a medical diagnosis
- PGT-A without a medical-necessity letter
- Donor egg/sperm costs
The math
Only medical expenses above 7% of AGI count, and only if you itemize instead of taking the standard deduction ($16,100 single / $32,200 married filing jointly for 2026). A couple with $175,000 AGI and $50,000 of unreimbursed IVF spend has about $36,900 above the floor; at a 24% bracket that is roughly $8,900 of tax — if they itemize.
HSA and FSA
IVF is HSA/FSA-eligible (2026 limits: FSA $3,400; HSA $4,400 self / $8,750 family). Bundled 'global' invoices without itemized services are the single most common reason HSA/FSA claims are flagged. Ask the clinic for a line-item invoice with dates of service.
Employer benefits and taxes
Carrot and Maven Wallet reimbursements are generally taxable income; Progyny-adjudicated benefits are not.