Paying for Adoption or Fertility Treatment, Costs and Credits

Building a family sometimes costs money before the child ever arrives. A couple facing infertility may spend more on treatment in two years than they spent on their wedding and first car combined. A family pursuing adoption may write checks for agency fees, legal work, home studies, and travel that add up to a year of private school tuition before the placement is final. And in both cases, the emotional weight makes it hard to think clearly about the finances.

The good news is that paying for adoption or fertility treatment is a solvable planning problem. The costs are large but knowable. A meaningful share can be recovered through the federal adoption tax credit, medical expense deductions, pre-tax accounts, and employer benefits that have expanded rapidly in the past few years. And with some structure, the money can be found without raiding retirement accounts or carrying high-interest debt into the early years of parenthood.

This guide covers what each path realistically costs, the tax and employer programs that offset it, and how to fund the gap. It is educational, not tax advice for your situation, and Attend coordinates with your CPA rather than preparing returns.

What Adoption Really Costs

Adoption costs vary enormously by path, and the ranges below reflect what families in Georgia commonly report. Every situation differs.

Private domestic adoption

Adopting an infant through a licensed agency or an adoption attorney typically costs $30,000 to $60,000. The total includes agency or attorney fees, the home study, birth parent counseling and permitted living expenses, legal fees for both sides, court costs, and travel if the birth occurs out of state. Some agencies charge a sliding scale based on income. Failed matches can add cost, since some expenses are not refundable if a birth parent changes her mind.

International adoption

International adoption generally runs $30,000 to $60,000 or more, depending on the country, with costs for the home study, agency and foreign program fees, immigration processing, document authentication, and one or more trips abroad. Timelines have lengthened as several countries have restricted or closed programs, which increases the risk of paying fees toward a placement that stalls.

Adoption from foster care

Adopting a child from Georgia's foster care system usually costs little or nothing. The state covers most legal and administrative costs, and many children qualify for adoption assistance payments that continue until age 18 or beyond, along with Medicaid coverage. This path involves different considerations, including the child's age and history and the possibility of reunification with birth family during the foster period, but the financial barrier is low.

What Fertility Treatment Really Costs

Fertility treatment is priced per procedure, and the total depends heavily on how many attempts it takes. Intrauterine insemination (IUI) is the lower-cost starting point, often several hundred to a few thousand dollars per cycle including medication and monitoring. In vitro fertilization (IVF) is the larger expense. A single IVF cycle in metro Atlanta, including medications, monitoring, retrieval, lab work, and transfer, commonly costs $15,000 to $25,000. Genetic testing of embryos, frozen embryo transfers, and storage fees add to that.

Because success rates per cycle are well below 100 percent, especially after the mid-30s, many patients need two or three cycles. A realistic planning figure for a full course of treatment is $40,000 to $75,000, and some families spend more. Egg freezing for future use generally costs $10,000 to $15,000 per cycle plus annual storage. Donor eggs, donor sperm, and gestational surrogacy sit in a different tier entirely, with surrogacy arrangements often exceeding $100,000 once agency, legal, medical, and compensation costs are included.

Georgia does not require health insurers to cover infertility diagnosis or treatment, so coverage depends entirely on the plan. Read the plan documents before treatment begins, and ask the clinic's financial counselor for a written estimate.

The Federal Adoption Tax Credit

The adoption tax credit is the single largest financial offset available to adopting families. It covers qualified adoption expenses such as agency fees, attorney fees, court costs, and travel, up to a maximum per child that the IRS adjusts for inflation each year. The maximum was above $17,000 for 2025, and the current figure is in the IRS adoption credit guidance. The credit phases out above an income threshold that also adjusts annually, and it is claimed on Form 8839.

Refundable portion and carryforward

Beginning with 2025 tax returns, up to $5,000 of the credit is refundable, meaning a family can receive it even if it exceeds their tax liability. The remainder is nonrefundable but can be carried forward for up to five years. For high earners, the phase-out is the main constraint. Families near the threshold sometimes benefit from timing deductible contributions, such as 401(k) or HSA deferrals, to reduce modified adjusted gross income in the year the credit is claimed. Our tax planning work coordinates that with your CPA.

Timing and special rules

For a domestic adoption, expenses paid before the adoption is final are claimed the year after they are paid, and expenses in the year of finalization are claimed that year. For an international adoption, the credit is available only once the adoption is final. A child determined by the state to have special needs, which in Georgia often includes children adopted from foster care, qualifies the family for the full maximum credit regardless of actual expenses. That rule alone can be worth more than $17,000 to a family adopting from foster care.

Employer adoption assistance

Many employers reimburse adoption expenses, and up to the same annual maximum can be excluded from income. You cannot claim the credit and the exclusion for the same dollars, but you can use both on different expenses. A family with $40,000 in expenses might exclude an employer reimbursement of $15,000 and claim the credit on the rest, subject to the cap.

Tax Treatment of Fertility Expenses

Fertility treatment gets less generous treatment than adoption, but there are still three tools.

Medical expense deduction

Costs of IVF, IUI, fertility medications, egg retrieval, and temporary storage of eggs or embryos are deductible medical expenses for the taxpayer, spouse, or dependents. The deduction only applies to expenses above 7.5 percent of adjusted gross income and only if you itemize, which limits its value for many high earners. In a year with $60,000 of treatment, a household with $300,000 of AGI could deduct roughly $37,500 if it itemizes. Surrogacy and donor-related expenses that do not involve the taxpayer's own body have generally been treated by the IRS as not deductible. See IRS Publication 502 for the list.

HSA and FSA dollars

Fertility treatment is a qualified medical expense for health savings accounts and healthcare flexible spending accounts. An HSA is especially useful because contributions are pre-tax and there is no deadline to spend them, so a couple who anticipates treatment can build the balance in advance. Our guide to the HSA triple tax advantage covers the mechanics. Elect the FSA during open enrollment in the year you expect treatment.

Employer fertility benefits

Fertility coverage has become a competitive benefit, and many large employers now offer a lifetime dollar allowance or a set number of IVF cycles through specialized benefit administrators. These programs can be worth $20,000 to $75,000 or more. If your employer does not offer one, the benefit is worth asking about, and it is a legitimate factor in comparing job offers. Some plans cover egg freezing and adoption assistance under the same program. Review the details during open enrollment.

Georgia Programs and Credits

Georgia offers a state income tax credit for families who adopt a child from the state's foster care system. The credit is worth several thousand dollars per year for a number of years after the adoption, and the details have changed with recent legislation, so confirm the current amount and eligibility on the Georgia Department of Revenue site. Georgia's adoption assistance program also provides monthly payments and Medicaid for eligible children adopted from foster care, which can continue until the child reaches adulthood.

For fertility treatment, Georgia has no state mandate or state credit, so the federal tools and employer benefits are the entire toolkit.

How to Fund the Gap

After credits, deductions, and employer benefits, most families still have a five-figure gap. The order of sources matters.

• Current cash flow. Treatment and adoption expenses arrive in stages over months or years. Redirecting savings contributions temporarily, while keeping the 401(k) match, often covers a large share without touching principal.
• Dedicated savings. Money set aside in advance in a high-yield savings account is the cleanest source. Couples who know they will pursue IVF or adoption within a year or two can build a specific fund, separate from the emergency fund.
• Taxable investment accounts. Selling appreciated holdings creates capital gains, but the tax cost is usually far less than the interest on a loan. Coordinate the sale with the year's tax picture.
• Clinic and agency payment programs. Many fertility clinics offer multi-cycle packages with partial refunds if treatment does not succeed, and some agencies allow staged payments. Read the terms carefully; refund programs often have eligibility limits and higher upfront prices.
• Loans. Home equity lines and personal loans are available and sometimes necessary. Fertility-specific lenders exist, often at higher rates. Avoid financing treatment on credit cards beyond a promotional period you are certain you can pay off.
• Retirement accounts, last. A 401(k) loan or an early IRA withdrawal is possible, and adoption and birth expenses qualify for a limited penalty-free retirement withdrawal under federal law, but pulling money out of tax-advantaged growth to fund a one-time expense has a long-term cost that most families underestimate.

Planning for What Comes After

The expense does not end at placement or a positive pregnancy test. Adoptive families often face post-placement supervision fees, finalization costs, and travel. Families who conceived through IVF may have frozen embryos with ongoing storage fees and decisions about future use. Everyone faces the ordinary costs of a new child: childcare, insurance changes, and a larger life insurance need. Our new baby financial checklist picks up where this guide ends, and our families page describes how we work with households at this stage.

Paying for adoption or fertility treatment is expensive, but it is not unbounded, and a surprising share of the cost can be recovered through the adoption credit, medical deductions, HSA and FSA dollars, employer programs, and Georgia's foster care incentives. The families who come through it in good financial shape decided the funding order in advance, used every benefit available, and kept their retirement accounts intact. If you are planning for either path and would like help mapping the costs and tax opportunities, our financial planning process is built for exactly this kind of milestone.

Tony Colunga · Founder, Attend Wealth

Tony leads Attend Wealth, a fee-based wealth management firm in Atlanta serving professionals, families, physicians, and business owners. Advisory services are held to a fiduciary standard. More about Attend