Over the past few decades the number of young, reproductive age cancer survivors has increased as a result of improved and less destructive cancer treatments. Certain types of cancers are predominantly diagnosed among reproductive age women and a small proportion of cancers originating in the reproductive tract are also detected in this age group. Treatment in the past used to be definitive and in most cases led to sterility. In recent years, improved medical treatments and more conservative surgical approaches have been introduced increasing the number of young survivors of cancer treatment. These less invasive treatments seem to be associated with similar survival rates and fertility can be preserved in most cases. This has led to studies evaluating the reproductive options of these women. Conservative surgical techniques, the use of chemotherapeutic agents with a reduced gonadotoxic side-effect profile, and the application of more focused radiation therapy are associated with maintenance of fertility. In addition, assisted reproductive technology (ART) has undergone tremendous improvements and now offers several alternatives to those who wish to maintain fertility before or even after cancer therapy. This review summarizes the fertility sparing medical and surgical as well as ART options that reproductive age women desiring to maintain fertility may utilize if they face cancer therapy.