FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. García VelascoImpact of underlying stress in infertilitySanta-Cruz, Diana C.a,b; Agudo, Davida,bAuthor Information aUniversidad Rey Juan Carlos bIVI-RMA Madrid, Madrid, Spain Correspondence to Diana C. Santa-Cruz, IVI-RMA Madrid, Avenida del Talgo, 68, 28023 Madrid, Spain. Tel: +34 911802900; e-mail: email@example.com Current Opinion in Obstetrics and Gynecology: June 2020 - Volume 32 - Issue 3 - p 233-236 doi: 10.1097/GCO.0000000000000628 Buy Metrics Abstract Purpose of review To review the latest findings about the impact of women's physiological stress on fertility treatment outcomes and the main biomarkers used. Recent findings 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. Summary 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. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.