Patients preparing to undergo therapies that pose a risk to their fertility or who are at risk of premature ovarian insufficiency should be provided prompt counseling regarding available options for fertility preservation. Fertility preservation can best be provided by comprehensive programs designed and equipped to confront the unique challenges facing these patients. This document replaces the document entitled “Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion,” last published in 2019.