Purpose <p>To examine fertility-related considerations of patients and survivors diagnosed with cancer during adolescence and young adulthood (AYA). Such fertility-related considerations include perceptions of putting reproductive goals “on hold” and subsequent effects on romantic relationships, parenthood considerations (i.e., arguments for/against having children), fertility-related uncertainty, and fertility-related concerns.</p> Methods <p>An online cross-sectional survey was completed by of <i>N</i> = 190 patients/survivors of AYA cancer (<i>M</i>_age = 32.5&#xa0;years, 87% female, diagnosed between ages 12–39&#xa0;years; 65% were without biological children at study participation).</p> Results <p>The majority of participants (72%) likely wanted to have children. Among them, 46% felt like their reproductive goals were put on hold due to cancer, causing negative emotions and negative effects on romantic relationships (e.g., pressure). Arguments against parenthood were predominantly <i>cancer-specific</i> (e.g., concerns/worries about health risks), but also <i>generic</i> (e.g., loss of freedom, sustainability). Arguments in favor of having children were almost all <i>generic</i> (e.g., meaning making). Fertility-related uncertainty caused negative emotions (e.g., sadness, insecurity, anxiety, feeling less human), and was correlated with various fertility-related concerns (<i>r</i> = .3–.7).</p> Conclusion <p>Perceptions of putting reproductive goals “on hold” can affect well-being and romantic relationships, and fertility-related uncertainty may cause various negative emotions among young cancer patients/survivors. Arguments against parenthood evolve around cancer-specific concerns, which should be addressed by healthcare providers throughout survivorship. Providers are encouraged to provide patient-specific fertility-related education and psychological support if indicated.</p>