The discussion of future fertility options should be considered an essential part of the treatment plan for young women having gonadotoxic therapy. Given the toxic effects of chemotherapy agents on the ovary, with the resultant risk of temporary and more permanent ovarian failure, the availability of options to preserve and protect fertility is of great importance to these young women and their families. Current options to preserve fertility in this patient population of women who undergo chemotherapy treatment are limited, but include preservation of embryos, oocytes, or ovarian tissue prior to cancer treatment, and ovarian protection with the use of gonadotropin-releasing hormone (GnRH) analogues throughout the duration of treatment. As the most extensively investigated endocrine marker, serum follicle-stimulating hormone (FSH) has been the most useful parameter for assessment of ovarian reserve. A combination of endocrine and biophysical parameters provides the best insight currently available into current and future ovarian function.