📋 Canada's Medical Expense Tax Credit for Fertility — How to Actually Claim It

Introduction

The Medical Expense Tax Credit (METC) is the single most under-claimed financial offset for Canadian fertility patients. The CRA permits you to claim a federal credit on qualifying medical expenses above a threshold — and almost every dollar you spend on fertility treatment qualifies. Done correctly, the METC can return $3,000–$8,000+ on a typical IVF year. Done sloppily, you leave thousands on the table.

This is the practical, line-by-line guide to claiming fertility expenses on your Canadian tax return.

How the credit actually works

The METC is non-refundable, calculated at 15 percent federally plus a provincial component (5–17 percent depending on province). The math:

• Add up all eligible medical expenses for any 12-month period ending in the tax year.
• Subtract the lesser of 3 percent of net income or $2,759 (2025 threshold; CRA updates annually).
• The remainder is multiplied by the combined federal + provincial credit rate (~20–32 percent depending on province).

Example: An Ontario household with $120,000 net income and $18,000 of fertility expenses gets roughly $3,000 back via the METC.

Pick the spouse with the lower net income to claim — the 3 percent threshold is smaller, so more expenses qualify.

What qualifies as a fertility medical expense

The CRA's interpretation is broad. Eligible:

• Clinic fees: consults, monitoring, retrieval, transfer, ICSI, freezing, storage, FET
• Diagnostic testing: AMH, FSH, HSG, semen analysis, genetic screening, ERA
• Prescription medications paid out-of-pocket (not the portion covered by insurance)
• PGT-A, PGT-M, PGT-SR genetic testing
• Donor sperm, donor egg, and donor embryo fees (CRA expanded eligibility in 2017 and again clarified for surrogacy in 2022)
• Surrogacy-related medical costs for the surrogate (Bill C-32, 2022 amendments)
• Reimbursements to surrogates and donors for expenses they incurred (medical, travel, lost wages — within the Assisted Human Reproduction Act framework)
• Travel: if treatment is more than 40 km from home, mileage / public transit is eligible; over 80 km, accommodation and meals also qualify
• Parking at the clinic and pharmacy
• Acupuncture if performed by an authorized medical practitioner in your province

Not eligible: cosmetic procedures, supplements/vitamins (unless prescribed), wellness coaching without medical credentials, doula services for fertility, most over-the-counter products.

The 2022 surrogacy expansion (huge)

Under Bill C-32, intended parents can now claim medical expenses paid on behalf of a surrogate or donor, even though those expenses are not for the taxpayer themselves. This was a major win. Includes:

• Surrogate's IVF cycle costs (medications, monitoring, transfer)
• Surrogate's prenatal care if you reimbursed her
• Egg or sperm donor's screening, retrieval, and medications
• Travel for surrogate or donor to a medical appointment (where you reimbursed)

Keep receipts in your name (or in the surrogate's name with proof of reimbursement).

Receipts and documentation

The CRA can ask for proof up to 6 years after filing. You need:

1. Itemized clinic invoices (not just credit-card statements). Most clinics will email an annual summary on request — ask in January.
2. Pharmacy receipts showing patient name, drug, dose, date, and amount paid. The pharmacist's annual printout is gold.
3. Insurance EOBs showing what was reimbursed (you can only claim the unreimbursed portion).
4. Travel logs: dates, kilometres, destination, purpose. Use the CRA simplified method (cents-per-km, updated annually — $0.61/km Ontario 2025) or detailed method with gas receipts.
5. Reimbursement records for surrogate/donor expenses (e-transfers, signed expense forms).

Common mistakes that trigger reassessments

• Claiming the insurance-covered portion. Only the out-of-pocket amount is eligible. The CRA cross-references with insurers.
• Missing the 12-month window. You can choose any 12-month period ending in the tax year — pick the window that captures the most expenses. Smart for patients who started in Q3.
• No itemization. "IVF cycle $12,000" on a credit card statement is not enough. CRA wants the clinic's line-item invoice.
• Claiming travel under 40 km. Hard threshold. Under 40 km, only the medical service itself counts, not travel.
• Forgetting the annual storage fee. Easy miss; it is eligible and recurring.

Picking the right 12-month window

This is the most-missed optimization. The METC allows any 12-month period ending in the tax year. If you started treatment in September 2025 and most spend was Sept 2025–Aug 2026, claim Sept 2025 to Aug 2026 on your 2026 return rather than splitting it across two tax years. Two smaller claims often both fall under the 3 percent threshold and yield zero credit; one big claim sails over the threshold.

Provincial top-ups

Several provinces add their own credit on top of the federal METC:

• Manitoba Fertility Treatment Tax Credit: 40 percent refundable on up to $20,000 of eligible expenses (max $8,000 back). Stacks with METC.
• Saskatchewan Fertility Treatment Tax Credit: 50 percent refundable on up to $20,000 (max $10,000 back). See our Saskatchewan FTTC guide.
• New Brunswick: One-time $5,000 grant (not a tax credit but stacks).

Working with an accountant

If your year's fertility spend exceeds $10,000, the cost of an accountant ($200–$500) usually pays for itself in catching missed items — especially around surrogacy and donor reimbursements. Ask specifically if they have done fertility files before; the eligibility rules have shifted three times since 2017.

A worked example

Montreal couple, 2026 tax year, joint income $140,000 (lower-earning spouse $55,000 net):

• IVF cycle (after RAMQ): $0
• Medications: $6,200
• ICSI: $1,800
• PGT-A: $5,500
• Storage: $500
• Travel (250 km total): $155
• Acupuncture (authorized): $1,200
• Total eligible: $15,355
• Minus 3 percent of $55,000 = $1,650
• Creditable: $13,705
• Federal + Quebec combined rate ~32 percent
• Refund: ~$4,385

Use the Navigator

The Fertility Link Navigator has a built-in METC estimator that pulls your province's combined rate and calculates expected refund based on the expenses you enter.

The bottom line

Claim the METC, claim the right 12-month window, save every itemized receipt, and pick the lower-income spouse to claim. For most Canadian fertility patients, that is $3,000–$8,000 back per year — money the CRA owes you that you have to ask for.