<p>Oncological diseases in women during reproductive age present patients and healthcare professionals with complex decisions, particularly with respect to fertility preservation. The choice of oncological therapy must not only be curative and guideline-compliant but also responsibly considered from a&#xa0;reproductive medicine perspective. Numerous forms of treatment, such as chemotherapy, radiotherapy or surgery, can permanently damage the ovarian reserve or uterine function. The gonadotoxic effects of new oncological therapies (e.g., immunotherapies or checkpoint inhibitors) are still unclear. This underlines the importance of advising young patients of reproductive age who have not yet started or completed their family planning about possible fertility preservation methods at an early stage. Established procedures include cryopreservation of oocytes, embryos (pronucleus stage) or ovarian tissue. Gonadotropin-releasing hormone (GnRH) analogues are also used for temporary ovarian suppression during chemotherapy, although this is sometimes controversially discussed. The choice of fertility preservation treatment depends on the type of tumor, the treatment regimen and the time window available before the start of oncological therapy. Surgical techniques, such as ovariopexy can be useful in cases where radiotherapy is planned. In any case, individual circumstances, such as age, ovarian reserve, family situation, risk profile and personal wishes of the patient must be taken into account. Current guidelines emphasize the need for standardized interdisciplinary counseling. If medically indicated before cytotoxic treatment the costs of fertility preservation procedures are covered by health insurances in Germany.</p>