Impaired fertility is a common consequence of cancer treatment. Actions to protect fertility taken in the crucial moment would therefore be of utmost importance for future quality of life in young cancer survivors. The decision for or against any procedure to preserve fertility, however, signifies an additional burden for all parties involved. The narrow timeframe between the diagnosis of cancer and the start of cancer treatment implies that the decision must be taken under considerable time pressure and is often associated with emotional chaos, alternating between fear of death and hope or euphoria. If patients, however, are not offered these options the psychological burden resulting from loss of fertility may persist lifelong. Based on the results of current research, psychological aspects in the context of fertility preservation in young female cancer patients will be presented and discussed with a special focus on the significance of fertility, the attitude towards fertility preserving techniques, the decisional conflict and the strategies to provide support.