To review the latest findings about the impact of women's physiological stress on fertility treatment outcomes and the main biomarkers used.Women with infertility report high levels of distress that can impact their treatment outcome. The combination of multiple methodologies in psychological stress evaluation result in higher validity, precision and richness in the data. Hair cortisol levels seem to be a promising biomarker to be associated to treatment outcomes.The impact of distress on treatment outcome can be assessed with the help of biomarkers. Decreasing burden of treatment may lead to relevant improvements in assisted reproductive technology outcome.