- Background/objectives/introduction Perceived stress and stress reduction interventions have a mixed relationship with fecundity. The objective of this study is to attempt and disentangle these relationships by looking at practicing stress reduction techniques and fecundity and examining their relationship to a behavioral and a neuroendocrine measure of stress. Materials and methods Fifty nulliparous-infertile women participated in a randomized prospective pilot study with repeated measures to examine the efficacy of cognitive behavioral interventions (CBI) in reducing perceived stress and improving pregnancy rates. Stress measures were taken at T0 (before CBI), T2 (ovum pick up) and T3 (time of pregnancy test). Results We found that women who reported low perceived stress at the beginning of treatment (T0) had a twofold increased chance of becoming pregnant (βhCG >7 mIU/mL) compared to those who reported high-perceived stress, regardless of CBI. Women who received CBI reported reduced perceived stress at the time of the pregnancy test (T3). Women who engaged in daily practice of CBI had significantly higher pregnancy rates compared to those who did not practice. Conclusions It may be beneficial for women who have high perceived stress levels to learn and practice stress reduction techniques before beginning IVF treatment, and continue to practice daily during IVF treatment.