Background <p>Individuals undergoing fertility treatments often experience heightened stress levels compared to the general population. With the increasing number of women facing recurrent failed in vitro fertilization (IVF) cycles, this research aimed to assess the effectiveness of positive thinking counseling and cognitive reconstruction in reducing perceived stress among infertile women.</p> Methods <p>A randomized controlled clinical trial was conducted with 57 women who had undergone unsuccessful IVF cycles at the Fatemiyeh Infertility Center in Hamadan, Western Iran. Using block randomization, participants were randomly assigned to the control group (29 participants)and the intervention group (28 participants). The intervention group received individual face-to-face positive thinking counseling and cognitive reconstruction in eight sessions, each lasting 45 to 60&#xa0;min. Stress levels were measured using the Cohen Perceived Stress Scale at the beginning of the study and on the embryo transfer day for both groups. Data were analyzed using Stata-13, with a significance levelof <i>p</i> &lt; 0.05.</p> Results <p>Both groups’ mean perceived stress scores showed no statistically significant differences before the intervention (<i>p</i> = 0.168). However, after the intervention, the mean perceived stress scores in the intervention group were significantly lower than those in the control group (<i>p</i> &lt; 0.001).</p> Conclusions <p>It appears that the use of these counseling approaches leads to a reduction in perceived stress among infertile women.</p> Trial registration <p>Registration Number: IRCT20120215009014N474, registered on May15, 2023.</p>