Expanded Tax Credits Ease Fertility Costs with METC and Ontario’s New Fertility Treatment Tax Credit

(CANADA) — Expanded tax credits for fertility treatment are now a central part of Canada’s tax support system, with Ontario’s new refundable credit adding a major new layer of relief for eligible residents.

For tax year 2026 (returns filed in 2027), intended parents and families should think in “layers.” Start with the federal Medical Expense Tax Credit (METC) rules. Then add the province-specific credits, where available.

The practical result is that some of the same treatment costs can support both federal and provincial claims, if you meet each program’s conditions.

This can be confusing, especially for newcomers and cross-border families. The key is to match (1) who paid, (2) when it was paid, (3) whether it was reimbursed, and (4) where the goods or services were provided.

What changed, and when it took effect

Two changes drive today’s planning:

1. Federal METC expansion (effective 2022 and later tax years). Canada broadened fertility-related expenses that can qualify as medical expenses. This includes certain costs tied to obtaining sperm, ova, or embryos through Canadian clinics or donor banks.
2. Ontario’s New Fertility Treatment Tax Credit (OFTTC) (effective January 1, 2025). Ontario added a new refundable credit for fertility treatment expenses that meet specific rules. Refundable matters because it can pay out even if you owe little tax.

Before/After comparison (what’s different now)

📅 Deadline Alert: For most Ontario residents, tax year 2026 returns are due April 30, 2027. Self-employed filers usually have a June 15, 2027 filing due date, but any balance is typically due April 30.

Who is affected most (including immigrants)

These expanded tax credits matter most for:

• Ontario residents paying out of pocket for IVF, IUI, medications, testing, freezing, storage, and related services.
• Newcomers to Canada who became Ontario residents partway through the year and paid eligible expenses after arrival.
• Cross-border families using donor material sourced abroad but working with Canadian clinics.
• Families using surrogacy or donor arrangements with substantial in-Canada medical and support costs.

Immigration status is not the main eligibility test for these credits. Tax residency and provincial residence generally are.

If you are new to Canada, confirm you were an Ontario resident on Dec. 31, 2026, for Ontario-specific claims.

If you are also a U.S. taxpayer, these credits may affect your U.S. return through foreign tax credit calculations. For U.S. residency rules, see IRS Publication 519 on the resident alien rules.

Section 1: Federal support — Medical Expense Tax Credit (METC) expansion

The Medical Expense Tax Credit (METC) is Canada’s core framework for medical expenses. It can often be claimed for expenses paid for yourself, your spouse or common-law partner, and certain dependants.

Since the 2022 expansion, the METC can cover a wider range of fertility-related costs. A practical point for intended parents is the treatment of reproductive material.

If you pay a Canadian fertility clinic or donor bank to obtain sperm, ova, or embryos, the expense can qualify even when the reproductive material originated outside Canada. That matters for families who use international donor banks, or who previously stored material abroad.

Surrogacy and donor-related costs require care. A useful way to think about the rule is “reasonable in-Canada goods or services.” Examples include medical procedures provided in Canada to a surrogate or donor, or necessary travel tied to those services.

Avoid claiming personal living costs, gifts, or payments that are not clearly medical in nature.

For cross-border families who also file U.S. taxes, keep separate folders for Canadian medical credit support and U.S. itemized deduction support. The U.S. medical expense rules differ. See IRS Schedule A (Form 1040) and guidance at the IRS forms and publications page.

Section 2: Ontario’s Fertility Treatment Tax Credit (OFTTC): key details

Ontario’s New Fertility Treatment Tax Credit is aimed at Ontario tax filers who incur fertility treatment expenses. It is refundable, so eligible taxpayers can benefit even with low Ontario tax payable.

Core conditions matter more than the procedure name.

In general, expenses must meet these guardrails:

• Goods and services must be provided entirely in Canada.
• The expense must also be claimed under the Ontario medical expense framework in the same tax year.
• The expense must not have been reimbursed, and must not be eligible for reimbursement, through private health insurance.

Eligible categories commonly include clinical treatment, medication, diagnostic testing, and certain professional fees connected to treatment. Travel can qualify in some cases when distance-based conditions are met. Track travel purpose and dates closely.

Coordination is where many errors happen. You generally do not “double count” by inventing two expenses. Instead, the same eligible medical expense can support multiple credits, if each credit’s rules allow it.

The safer practice is to prepare a single master list of paid expenses, then map it to each claim line.

⚠️ Warning: The most common denial issue is reimbursement. If your employer plan could have reimbursed it, the province may treat it as ineligible.

Section 3: Ontario OFTTC: financial impact and administration notes

Ontario has projected $160 million in relief over three years. That signals broad use, and it often leads to compliance reviews.

Ontario has also scheduled a comprehensive review after five years. Reviews can tighten definitions, adjust administration, or add documentation requirements.

Taxpayers should plan conservatively:

• Keep invoices consistent year over year.
• Use clear payment proof that matches the tax year.
• Document “why this cost was necessary” for borderline items, such as travel or ancillary services.

If you are planning multi-year treatment, assume you may need to defend the claim later. Build your file as if it will be reviewed.

Section 4: Quebec: income-based refundable credit for IVF and artificial insemination

Quebec offers a refundable credit for IVF and artificial insemination that varies by family income. That income-based structure changes planning.

When a credit rate changes with income, timing can matter. A bonus year, a job change, or moving in or out of the province can shift your expected support.

Practical steps for tax year 2026:

• Estimate family income early in 2026 if treatment is planned.
• Keep treatment start dates, payment dates, and clinic attestations aligned to the year you intend to claim.
• If your income changes late in the year, revisit your expected credit amount.

Section 5: Saskatchewan: lifetime fertility treatment credit

Saskatchewan’s approach is different. It provides a refundable credit but limits the claim to one lifetime fertility treatment expense claim per filer.

A lifetime limit changes the decision. Instead of asking “what can I claim this year,” you ask “which year is best to use my one claim.”

That often means:

• Choosing a year with the largest eligible out-of-pocket costs.
• Coordinating with other credits that depend on the same expense base.
• Confirming the current provincial schedule and lines before filing, since forms can change.

Section 6: Manitoba: enhanced support for fertility treatment

Manitoba increased its annual eligible cost limit for the 2024 tax year. For families with high-cost treatment years, higher eligible limits can increase the usable credit.

The planning lesson for 2026 is simple. If you incur substantial costs, your file must be clean:

• Invoices should identify the patient and service.
• Payment proof should match invoice totals.
• Large claims deserve extra documentation, even when the expense feels straightforward.

Section 7: Practical considerations for claiming credits

A claim-ready workflow helps prevent reassessments.

1. Build an audit trail. Keep invoices, receipts, and proof of payment together. Make sure dates match the tax year you claim.
2. Check reimbursement before you file. Confirm what private insurance paid. Confirm what it could have paid. Save the insurer’s explanation of benefits.
3. Coordinate federal and provincial claims. Treat your medical expenses like one shared pool. Then apply each credit’s rules to that pool. Do not add the same expense twice.
4. Get professional help when facts are complex. This includes surrogacy agreements, donor arrangements, cross-border payments, mixed residency, or moving provinces mid-year.

If you are also filing in the United States, confirm whether you are a U.S. tax resident under IRS rules. Start with IRS international taxpayers guidance and Publication 519.

Recommended actions and timeline (tax year 2026, filed in 2027)

• Now through Dec. 31, 2026: Save invoices and proof of payment as you go. Track reimbursements and travel logs.
• January–March 2027: Reconcile totals by tax year. Request missing receipts and insurer statements.
• By April 30, 2027: File your 2026 return and claim eligible credits. Consider professional review for large claims.
• If selected for review later: Respond using your organized expense list and supporting documents.

⚠️ Disclaimer: This article is for informational purposes only and does not constitute tax, legal, or financial advice. Tax situations vary based on individual circumstances. Consult a qualified tax professional or CPA for guidance specific to your situation.