Can You Deduct IVF in Mexico on Your US Taxes?

Short version: Yes, in principle. The IRS treats IVF as medical care, and care received in Mexico generally counts, so it can go toward the medical expense deduction and can usually be paid with HSA or FSA money. In practice, the deduction helps fewer people than they hope: you only deduct medical costs above 7.5% of your adjusted gross income, and only if you itemize instead of taking the standard deduction. Some travel counts, meals don't, lodging is capped at $50 a night, and medications you buy in Mexico and bring home generally don't qualify. Here's how it works, with a worked example.

We're not tax advisers. This is a plain-language summary of public IRS guidance (mainly Publication 502). Confirm your situation with a tax professional.

The Two Ways Taxes Can Help

1. HSA and FSA accounts. If you have a Health Savings Account or a Flexible Spending Account, you can usually use it to pay qualified medical expenses, including IVF, with pre-tax money. For most people this is the more valuable of the two, because there's no income threshold and no need to itemize.

2. The itemized medical expense deduction. On Schedule A, you can deduct qualified medical expenses for yourself, your spouse and your dependents, but only the portion above 7.5% of your adjusted gross income (AGI), and only if your total itemized deductions beat your standard deduction.

You can't do both with the same dollars: expenses paid from an HSA or FSA aren't deductible again.

Does IVF Done in Mexico Qualify?

IVF itself qualifies. IRS Publication 502 lists fertility treatment, including in vitro fertilization and temporary storage of eggs or sperm, among deductible medical expenses.

Care received outside the US can qualify, as long as it's legal medical care. Legitimate IVF at a licensed Mexican clinic generally meets that test. The IRS doesn't allow deductions for treatment that is illegal, so stick to standard, legal treatments, and keep proof of what you paid for.

The expense must be for you, your spouse or your dependent, and you deduct it in the year you pay it. Card payments count in the year you charge them, even if you pay off the card later.

What Counts and What Doesn't

Expense	Generally counts?
Consultations, monitoring, retrieval, lab work, transfer	Yes
ICSI, embryo culture, PGT-A testing	Generally yes, as part of treatment
Egg, sperm or embryo freezing and storage connected to treatment	Generally yes
Prescription fertility drugs bought in the US	Yes
Prescription drugs bought and used in Mexico, legal in both countries	Yes
Prescription drugs bought in Mexico and brought home	Generally no, unless the import is legal
Airfare or mileage primarily for treatment	Yes
Lodging away from home for treatment	Yes, up to $50 per night per person, with conditions
Meals while travelling	No (except meals at a hospital as an inpatient)
Sightseeing and vacation days	No
Supplements, vitamins and non-prescribed add-ons	Generally no

Travel: Flights, Mileage, Lodging and Meals

Transportation counts if it's primarily for and essential to medical care: airfare, taxis and rideshares to the clinic, parking, tolls, and either actual car expenses or the IRS medical mileage rate (about 20 cents a mile in recent years).

Lodging counts, with limits. You can include lodging while away from home for medical care if the stay is primarily for and essential to that care, it isn't lavish, and the care is provided by a doctor in a licensed hospital or an equivalent medical facility. The amount is capped at $50 per night per person. A companion's lodging can count when travelling with the patient is necessary; the IRS's own example is a parent with a sick child. Whether a companion qualifies for an adult IVF patient depends on the facts, so ask your tax adviser.

Meals don't count, except meals provided by a hospital during inpatient care.

Mixed trips. If you add vacation days, only the medically necessary part counts. Keep your treatment dates documented.

Medications Bought in Mexico

This is the rule that trips people up:

• Drugs bought and used in Mexico can count, but only if they're legal in both Mexico and the United States.
• Drugs bought in Mexico and brought back to the US generally don't count unless they were imported legally under FDA rules.

If you want medication costs to count, buying them in the US or using them during your stay in Mexico is cleaner from a tax perspective. (Carrying personal medication across the border has its own customs rules; declare it.)

Donors, Surrogacy and Whose Treatment It Is

The deduction is for medical care of you, your spouse or your dependents. That creates gray areas:

• Egg or sperm donor costs. The IRS has allowed donor-related costs as part of a taxpayer's own fertility treatment in a private letter ruling. Private rulings apply only to the person who requested them, but they indicate how the IRS has viewed similar facts.
• Surrogacy. US courts have rejected deductions for a gestational carrier's medical costs, because the carrier isn't the taxpayer, spouse or dependent.
• Single people and same-sex couples. Costs directly for your own medical care (for example, your egg retrieval or sperm collection and related lab work) are on firmer ground than costs for another person's care. Rules in this area have been tested in court and in private rulings, so get professional advice.

A Worked Example: Will the Deduction Actually Help You?

The deduction only helps if your total itemized deductions exceed your standard deduction. For illustration, assume a standard deduction of about $32,000 for married couples filing jointly and about $16,000 for single filers; check the current year's figures.

Couple A: married, AGI $100,000

Item	Amount
IVF in Mexico plus qualifying travel	$13,000
Other medical costs that year	$1,500
Total medical	$14,500
Minus 7.5% of AGI	−$7,500
Deductible medical	$7,000
Mortgage interest	$11,000
State and local taxes	$9,000
Total itemized	$27,000

Total itemized deductions of $27,000 are below the $32,000 standard deduction. The IVF deduction gives this couple no tax benefit at all. Paying through an HSA or FSA would have been worth far more.

Person B: single, AGI $70,000, owns a home

Item	Amount
IVF in Mexico plus qualifying travel	$12,000
Minus 7.5% of AGI	−$5,250
Deductible medical	$6,750
Mortgage interest and state/local taxes	$12,000
Total itemized	$18,750

That's about $2,750 above the illustrative $16,000 standard deduction. At a 22% marginal rate, the saving is roughly $600. Useful, but far less than the $12,000 spent.

The takeaway: if you have an HSA or FSA, use it. If you don't, run the numbers before counting on the deduction. And remember that one large medical year (a cycle plus a delivery, for example) can push you over the line when a smaller year wouldn't.

Records to Keep

• Itemized invoices from the clinic, ideally a formal Mexican invoice (factura), in English or with a translation.
• Proof of payment: card statements, transfer confirmations.
• The exchange rate you paid at, or the rate on the date of payment, to convert peso amounts to dollars.
• Prescriptions and pharmacy receipts, showing where each drug was bought and used.
• Travel records: boarding passes, mileage logs, hotel invoices, with dates that match your treatment.
• Medical records showing the dates and nature of treatment.

Keep them for at least as long as the IRS can review your return, generally three years from filing, and longer is safer. For paying the clinic itself, see How to Transfer Money & Pay for IVF in Mexico.

This article is information, not tax or legal advice. Tax rules and amounts change annually; confirm your situation with a qualified tax professional. Canadian readers: see IVF in Mexico for Canadians for the medical expense tax credit.