Background <p>Cancer treatments often pose significant risks to fertility, particularly among women diagnosed during their reproductive years. In vitro fertilization (IVF) and related assisted reproductive techniques have become essential strategies for fertility preservation in these patients. However, concerns persist regarding the potential cancer risks associated with fertility treatments, particularly hormonal stimulation, necessitating a balanced evaluation of the benefits and potential harms.</p> Results <p>This review evaluates current IVF-based fertility preservation techniques, their efficacy, safety, and implications for cancer patients. Key fertility preservation strategies discussed include ovarian transposition, embryo cryopreservation, controlled ovarian stimulation protocols for cancer patients, and ovarian tissue cryopreservation. These methods allow preservation of reproductive potential without substantially delaying essential cancer therapies. Emerging technologies such as artificial intelligence-driven embryo selection and personalized stimulation protocols are highlighted for their potential to enhance reproductive outcomes and reduce hormonal exposure, thereby mitigating theoretical risks associated with fertility medications. Nonetheless, the relationship between fertility treatments and cancer remains complex. While most extensive cohort studies suggest minimal or no significant increase in breast cancer risk following fertility treatment, certain subgroups, including women undergoing multiple hormonal stimulation cycles or those genetically predisposed to cancer, may experience slightly elevated risks. Additionally, there is growing evidence indicating an increased risk of specific cancers, particularly paediatric hepatic tumours, among children conceived through IVF procedures. These findings underscore the importance of ongoing research and cautious interpretation of fertility treatment-associated risks.</p> Conclusion <p>IVF-based fertility preservation strategies offer critical reproductive options for women undergoing cancer treatment. Although generally safe, the nuanced relationship between fertility treatments and cancer risks emphasizes the importance of personalized, evidence-based approaches. Continued research, interdisciplinary collaboration, and comprehensive patient counselling are essential to optimize reproductive outcomes and safeguard the long-term health of cancer survivors and their offspring.</p> Graphical abstract <p></p>