Part of our guide: Fertility treatment cost

This page covers Germany, Austria, and Switzerland.

Are you thinking about fertility treatment and wondering whether you can deduct the costs on your taxes? The good news: Yes, you can! In Germany, you can claim the portion you pay yourself as an extraordinary burden. For tax purposes, only the portion above your reasonable burden counts, and that burden depends on your income, marital status, and number of children.

For many couples, the financial strain of fertility treatment is just as challenging as the emotional one. That is why you should know every option for getting your expenses back.

The tax deductibility of fertility treatment costs is a complex topic. It depends on many factors: your marital status, the type of treatment, and even whether you live in Germany, Austria, or Switzerland. Here you will learn how to get the most out of your tax return.

What you can deduct and what you can't

The basic rule is simple: Fertility treatment counts as medical costs if a fertility disorder makes the treatment necessary and the treatment is compatible with professional medical law and German law. Anything that is merely a wish doesn't count. Sounds clear at first, right? In the details, it gets more complicated.

This is definitely deductible

Treatment costs are the big item. According to the Federal Institute for Public Health (Bundesinstitut für Öffentliche Gesundheit), IVF costs self-pay patients around €3,200 to €3,600 per attempt, and ICSI from around €3,500. Individual clinics charge considerably more for ICSI, a Munich practice for example €6,200 to €6,900 plus anesthesia, lab, and medication. For hormone medication, clinics quote €400 to €2,000 per cycle. You can find more under IVF costs and ICSI costs. You can claim the portion you pay yourself. Of that, only what exceeds your reasonable burden has a tax effect.

Preliminary tests count too. The semen analysis, blood tests, ultrasound appointments. All deductible, as long as you pay for them yourself. You can even claim the travel costs to the clinic. If you drive, the tax office (Finanzamt) generally recognizes only the amount that bus and train would have cost, according to the official income tax guidance (H 33.1-33.4 EStH). You get more only if there was no reasonable connection by public transportation.

A worked example: A married couple with statutory health insurance goes through three IVF attempts in 2025 with an approved treatment plan. The clinic then bills at health insurance fund rates, and the insurance fund covers half. According to the itemized prices of the fertility practice vitro-med, the out-of-pocket cost is about €1,486 per IVF attempt, medication included. For three attempts, that comes to about €4,459. The couple claims this amount as an extraordinary burden. For tax purposes, however, only the portion above their reasonable burden has an effect.

Unfortunately, this doesn't work

Wellness treatments are off limits. Acupuncture “for relaxation,” a massage “for better circulation”: not deductible without a doctor's prescription. Dietary supplements are also problematic, unless the doctor prescribes them specifically for the treatment.

Treatments that are incompatible with German law are also not deductible. The Federal Fiscal Court (Bundesfinanzhof, BFH) has expressly decided this for egg donation abroad (2022) and for surrogacy abroad (2023).

Gray area: preventive measures

Here it gets interesting. Elective egg freezing costs of €2,500 to €4,000 are deductible only if there is a medical indication. Cancer patients before chemotherapy? Definitely yes, although the statutory health insurance fund pays for the freezing anyway in that case. Career planning? Definitely not.

Medical receipts and invoices on a desk for the tax return

Extraordinary burdens explained

The term sounds complicated, but it is your friend. Extraordinary burdens are expenses that you incur out of necessity and that most people don't have. Fertility treatment usually falls into this category if an illness underlies it.

The three requirements

First: extraordinary nature. IVF treatment is not an everyday event. That automatically meets this requirement. Second: necessity. You need the treatment in order to get pregnant despite a fertility disorder. That, too, is usually met. Third: appropriateness. The costs must be proportionate.

An important 2024 ruling (BFH, VI R 2/22): A healthy woman was allowed to deduct her costs for assisted reproduction with preimplantation genetic testing (PGT) that was necessary because of a chromosomal change in her partner. This included the treatment steps on her own body, and the couple was not married. Whether this applies to every treatment beyond PGT has not been expressly decided by the Federal Fiscal Court. For ICSI because of the man's reduced sperm quality, it already considered the costs deductible in 2017 (VI R 34/15), provided the treatment is compatible with the Embryo Protection Act (Embryonenschutzgesetz).

Timing is everything

You deduct the costs in the year in which you paid them (outflow principle, Section 11 of the German Income Tax Act, Einkommensteuergesetz, EStG). Not necessarily in the year in which the treatment took place. That can make a big difference.

Example: A woman buys her IVF medication in December 2025 but doesn't start stimulation until January 2026. The medication costs belong in the tax return for 2025. The treatment costs she pays in January belong in the one for 2026.

Important: Only what you ultimately bear yourself is deductible. You subtract reimbursements and subsidies, for example from private health insurance, from the civil servants' health allowance (Beihilfe), or as a bylaw benefit from your statutory health insurance fund. This also applies if the money only arrives in a later year (H 33.1-33.4 EStH, “reimbursement from third parties”). Grants from the federal government and the state for fertility treatment are not specifically mentioned there. But they are also reimbursement from third parties, and under this principle they reduce the deductible costs.

Petri dish and pipette in a reproductive medicine lab

Calculating the reasonable burden

Here comes the catch: You have to bear part of the cost yourself. The “reasonable burden” depends on your total amount of income, your marital status, and the number of your children. Only what lies above it has a tax effect.

How to calculate your reasonable burden

The formula is tiered. These percentages apply under Section 33(3) EStG:

Total amount of income No children (basic rate) No children (married couples, splitting rate) 1 or 2 children 3 or more children
up to €15,340 5% 4% 2% 1%
over €15,340 to €51,130 6% 5% 3% 1%
over €51,130 7% 6% 4% 2%

Important: Since a 2017 ruling by the Federal Fiscal Court, the calculation is done in steps. Only the part of your income that exceeds a threshold is charged at the higher percentage.

An example: Your total amount of income is €45,000 per year, and you have one child. Your reasonable burden is €15,340 × 2% plus €29,660 × 3%, so about €1,197. You can deduct all fertility treatment costs above €1,197.

Married couples have advantages

With joint assessment, the combined total amount of income counts, and the lower percentages of the splitting rate apply. Example: She earns €60,000, her husband €20,000. Together they have €80,000. Without children and calculated in steps, that gives €613.60 plus €1,789.50 plus €1,732.20, so about €4,135 of reasonable burden.

Woman sorting fertility treatment documents for the tax return at a desk

Which documents you need

The tax office wants proof. Collect all receipts and keep them well organized. That saves you trouble later. It's best to document everything starting with your first consultation.

These documents are required

Doctor's invoices are the be-all and end-all. They must clearly show the reason for the treatment and the type of service. “IVF treatment for infertility” is perfect. “Consultation” is too vague.

You also need receipts for medication. Important: Keep the doctor's prescription (or a copy of it) with them. It proves that the medication was prescribed by a doctor. Pharmacy receipts alone are often not enough.

For larger amounts, the tax office sometimes wants a medical report. It should explain the diagnosis and why the chosen treatment is necessary. Ask your doctor for it early.

How to organize your receipts

A simple system helps: One folder per year, sorted chronologically. In front, a list with the date, amount, and type of service. That makes your tax return a breeze.

Digital is fine too. Important: Good image quality when scanning. The tax office has to be able to read everything. And don't forget the travel costs. Keep a small travel log for your trips to the clinic.

Married vs. unmarried couples

There are important differences here. Case law has developed considerably in recent years, mostly in favor of unmarried couples.

Married couples: the standard case

With joint assessment, your income is taxed together. It therefore doesn't matter which of you pays the bills: The costs reduce your joint income, and the savings depend on your joint tax rate.

Example: She earns €70,000, he earns €35,000, so €105,000 together. Without children, the reasonable burden, calculated in steps, is about €5,635. Of €8,000 in treatment costs that you bear yourselves, about €2,365 therefore have a tax effect.

Unmarried couples: once difficult, now doable

For a long time, the legal situation was unclear. Can the healthy partner deduct? Do both partners have to be treated? As early as 2007, the Federal Fiscal Court decided that unmarried couples in a steady relationship can also deduct fertility treatment costs. In 2017, it considered the costs of ICSI because of the man's reduced sperm quality deductible even though the couple was not yet married at the time, provided the treatment is compatible with the Embryo Protection Act (VI R 34/15). In 2024, a ruling on preimplantation genetic testing followed (VI R 2/22): A healthy partner was allowed to deduct her costs for assisted reproduction with PGT that was necessary because of a chromosomal change in her partner.

Important here: In each case, only the person who bears the costs themselves can deduct them. If only one of you pays, only that person can deduct. Does your partner transfer money to you for the treatment? Document that well. Keep bank statements as proof.

Here is how it works in practice, using an example: An unmarried couple splits the assisted reproduction costs of €12,000 in half. Each can claim €6,000 as extraordinary burdens (minus each person's reasonable burden, of course).

Same-sex couples and singles

Legally, this is where it gets especially interesting. Case law has developed, but not all cases are clearly settled.

Same-sex couples

Married same-sex couples are assessed jointly for tax purposes like other married couples. For the deductibility of sperm donation or IVF treatment, however, an important restriction applies: The Federal Fiscal Court (2017, VI R 47/15) recognizes the costs including donor sperm if the woman being treated has infertility. From this, it can be inferred that the lack of a male partner alone is not enough. The Federal Fiscal Court has not expressly decided this question, however.

The same applies to unmarried same-sex couples: What matters is the infertility of the woman being treated, not marital status.

Example: Two women live together but are not married. For their IVF with donor sperm, they pay €9,500 together. One of them carries the pregnancy, the other pays half of the costs. The costs are deductible if infertility was diagnosed in the woman being treated. How best to split the costs between the two of them is something you can clarify with a tax advisor if in doubt.

Singles: the most difficult case

Here, the legal situation is the least settled. So far, there has been no ruling by the Federal Fiscal Court specifically on single women. In 2020, the Fiscal Court of Münster (Finanzgericht Münster) decided that the costs of fertility treatment with sperm donation for single women are deductible if the woman was diagnosed with illness-related infertility. Marital status played no role.

Whether the lack of a partner alone is enough has not been decided by the Federal Fiscal Court. Its rulings so far have each focused on an illness. Without a medical diagnosis, you should therefore not count on a deduction. In addition, the treatment must be appropriate and consistent with professional medical law.

Modern tax advisory office for fertility cost questions

Tax deductibility in Austria

Austria has a different system than Germany. Here, direct funding through the IVF Fund (IVF-Fonds) is the main focus, and for tax purposes usually only the co-payment is left.

The Austrian system

The costs of medically indicated IVF can also be an extraordinary burden in Austria if the infertility was not brought about voluntarily. Only what you bear yourself is deductible: Cost reimbursements such as the Fund's share are subtracted. In addition, an income-dependent deductible of 6% (income up to €7,300), 8% (up to €14,600), 10% (up to €36,400), or 12% (above that) applies. Only what lies above it has a tax effect.

The IVF Fund covers 70% of the costs for up to four attempts. The remaining 30% is your co-payment, around €970 to €1,330 per attempt, depending on age, method, and center. You can claim this amount. It only has an effect, however, to the extent that, together with your other medical costs, it exceeds the income-dependent deductible.

Special features in Austria

With the IVF Fund, medication is already included in the rate, so you pay 30% for that too. Only this portion that you bear yourself is deductible. So hold on to the clinic's invoices.

You can claim travel costs to the clinic here as well. With long journeys, a lot adds up.

An example: A couple from Innsbruck travels to Vienna for IVF treatment. 500 kilometers per trip, five appointments. That is 2,500 kilometers for the outbound trips alone, so a four-figure amount quickly adds up.

Tax optimization in Austria

There isn't much room to maneuver: You can deduct only the portion you actually bear, minus the deductible. The deductible drops by one percentage point each if you are entitled to the sole-earner tax credit (Alleinverdienerabsetzbetrag) or the single-parent tax credit (Alleinerzieherabsetzbetrag), and for each child. So collect all medical costs from a year, because they are added together.

Tax deductibility in Switzerland

In Switzerland, mandatory basic health insurance (Grundversicherung) pays only for insemination (a maximum of three cycles per pregnancy); you bear IVF and ICSI yourself. The tax side is all the more important.

Medical costs in Switzerland

For direct federal tax, you can deduct medical costs to the extent that you bear them yourself and they exceed 5% of your income reduced by certain deductions. At CHF 60,000, that comes to a CHF 3,000 deductible. According to the Swiss Federal Tax Administration, hormone treatment, insemination with the partner's sperm, and IVF count as deductible medical costs, even when they are incurred by the healthy partner.

Because basic health insurance does not pay for IVF, you can claim the IVF costs you bear yourself above the deductible. Starting with tax period 2027, this also applies to freezing eggs, if it is illness-related and medically indicated.

Supplemental insurance and taxes

This is where it gets complicated. Premiums for supplemental insurance do not count as medical costs. Services that you pay for yourself despite having supplemental insurance, on the other hand, do.

Differences between cantons

For cantonal and municipal taxes, each canton sets its own deductible for medical costs. Find out the exact rules from your cantonal tax administration.

Practical example with concrete numbers

A fully worked-out, fictional example shows how the tax savings are calculated. With your own numbers, it goes faster in the cost calculator, which calculates insurance, funding, and taxes together, including under Austrian and Swiss law.

The example: a married couple with statutory health insurance

Suppose a married couple with statutory health insurance: He is 38 and earns €75,000, she is 35 and earns €45,000. They have been trying to get pregnant for three years and decide on IVF treatment in 2025.

The costs in detail

With an approved treatment plan, the clinic bills IVF at health insurance fund rates, not under the private fee schedule for physicians (GOÄ). As an order of magnitude, we use the itemized prices of the fertility practice vitro-med: out-of-pocket cost of about €1,486 per IVF cycle, medication included. The couple therefore paid the following themselves:

  • Preliminary tests (both partners, paid privately): €850
  • Out-of-pocket cost, IVF cycle 1: €1,486
  • Out-of-pocket cost, IVF cycle 2 (after miscarriage): €1,486
  • Additional blood tests: €320
  • Travel costs (20 appointments, claimed at bus and train fares, assuming €15 per appointment): €300
  • Paid by the couple: €4,442

Subtracting reimbursements

The statutory health insurance fund covers the other half of the costs, so using the vitro-med figures, also about €2,973 for both cycles. The couple does not pay this part themselves, so it does not appear in the tax return. Requirements for the insurance benefit:

  • married, only the couple's own eggs and sperm
  • both at least 25, the woman younger than 40, the man younger than 50
  • a maximum of three IVF or ICSI attempts

If the couple additionally received a bylaw benefit from their insurance fund or a grant from the federal government and the state, that would reduce the amount further.

Out-of-pocket cost: €4,442

Calculating the reasonable burden

Total amount of income: €120,000, married, no children Reasonable burden (in steps, splitting rate): €15,340 × 4% plus €35,790 × 5% plus €68,870 × 6% = about €6,535

Here comes the shock: The reasonable burden is higher than the out-of-pocket costs! The couple can't deduct anything for tax purposes.

Plan B: optimization over several years

And what if the couple had spread the treatments over two years? First attempt in 2025, second in 2026. The out-of-pocket cost per year would then be even smaller, but the reasonable burden of about €6,535 applies anew every year because it depends on annual income. Still no tax benefit. Conversely: Anyone who bundles high costs into one year is more likely to exceed the threshold.

The reality with high incomes

The example shows: With high incomes, the reasonable burden is often so high that normal treatment costs do not exceed it. Tax benefits usually only arise with:

  • Complications with additional costs
  • Multiple treatments in the same year
  • Special procedures such as PGT

Frequently asked questions

Can I deduct costs even without a medical infertility diagnosis?

This is one of the most common questions on the topic. The answer: Yes and no. Fertility treatment costs are deductible as medical costs. So you need a medically diagnosed fertility disorder in you or your partner, and the treatment has to be medically indicated.

In concrete terms: If you have been trying unsuccessfully to get pregnant for a year (for women over 35, after just six months), and the doctor therefore considers treatment necessary, there is a lot in favor of deductibility.

For same-sex couples and singles, the rule is: The costs are deductible if the woman being treated herself has infertility (BFH, VI R 47/15). From this, it is inferred that the lack of a male partner alone is not an illness. A ruling that expressly says so does not exist, however.

Can the costs for the healthy partner also be deducted?

In many cases, yes. In 2024, the Federal Fiscal Court decided (VI R 2/22) that a healthy woman can deduct her costs for assisted reproduction with preimplantation genetic testing (PGT) if the treatment is necessary because of her partner's illness. This includes the treatment steps on her own body. The case involved a chromosomal change in the partner. Whether the ruling applies to every fertility treatment has not been expressly decided.

Example: In an ICSI treatment, she is healthy and he has poor sperm values. For this situation, the Federal Fiscal Court already ruled in 2017 (VI R 34/15): The costs of ICSI can be deductible as an extraordinary burden, even for a couple that was unmarried at the time, provided the treatment is compatible with the Embryo Protection Act. ICSI also includes the hormone treatment and the egg retrieval on her side.

Important for unmarried couples: In each case, only the person who bears the costs themselves can deduct them. If only one of you pays, only that person can deduct. Document your mutual payments well.

What about treatment abroad?

Treatment abroad is deductible if it is compatible with German law, that is, if it would be permissible under professional medical law in at least one German state. This is how the Federal Fiscal Court recognized IVF with donor sperm in Denmark in 2017, including travel and accommodation costs.

Not deductible, however, are treatments that are prohibited in Germany: The tax office does not recognize egg donation abroad (BFH 2022) or surrogacy abroad (BFH 2023).

For permissible treatments, keep all invoices, medical records, and travel receipts. Travel and accommodation costs are then deductible as well.

What about alternative treatment methods?

This is legally disputed. Acupuncture, traditional Chinese medicine (TCM), or homeopathy are deductible only if they were prescribed by a doctor and are directly connected to the fertility treatment.

An example: Your fertility specialist prescribes acupuncture alongside your hormone treatment. With the corresponding prescription, it is deductible.

If you do acupuncture on your own “because it might help too,” it is not deductible. The clear medical indication has to be there.

Are dietary supplement costs deductible?

Generally no, unless they are prescribed by a doctor specifically for the fertility treatment. Folic acid before and during pregnancy is a borderline case. Some tax offices recognize it, others don't.

Special fertility vitamins or coenzyme Q10 have better chances if the doctor explicitly prescribes them for the treatment. Have a corresponding prescription issued.

The tax deductibility of fertility treatment costs is complex, but possible in many cases. With the right documentation and planning, you can get part of your expenses back. If you are unsure which treatment is right for you or how the costs will develop, use our Fertility Clinic Finder to find the right clinic. For tax planning in your individual case, it is worth consulting a tax advisor or a wage tax assistance association (Lohnsteuerhilfeverein).

Sources

FE

About this article

Fertilio Editorial Team

The Fertilio Editorial Team researches fertility topics using specialist sources such as the German IVF Registry (Deutsches IVF-Register, D.I.R.), medical guidelines, and statutes. The sources are listed at the end of each article. The content does not replace medical advice.