Background As advances in oncology have led to remarkable and steady improvements in the survival rates of cancer patients and anticancer treatment can cause premature ovarian failure in women, fertility preservation has become a global public health concern and an integral part of the care for women diagnosed with cancer during reproductive age. However, for various reasons, fertility preservation remains underutilized for cancer patients. There are substantial gaps in our knowledge about women’s experience and perceptions on the issue. This study aims to contribute to bridging that gap. Methods This prospective qualitative study was conducted from March 2018 to February 2023. A combination of purposive and snowball sampling was used. Data were collected by semi-structured interviews with nineteen reproductive-age women with a recent cancer diagnosis. Data were classified and analyzed by a thematic analysis approach. Results A variety of distinct themes and subthemes emerged from the analysis of the interview data. The cancer diagnosis emerged as a factor that considerably affects the women’s attitudes towards biological parenthood: It can further increase their (strong) previous desire or decrease their previous (weak) desire. Women with a recent cancer diagnosis did not receive adequate and multidisciplinary counselling, including clear and sufficient information. However, participants felt satisfied from the information they received because they either received the information they requested or remained in denial to get informed (i.e. because they felt overwhelmed after the cancer diagnosis). Embryo cryopreservation emerged as a less desirable fertility preservation option for women with cancer. Participants showed respect for human embryos, not always for religious reasons. Surrogacy emerged as the last resort for most participants. Religious, social or financial factors did play a secondary (if any) role in women’s decision making about fertility preservation. Finally, male partners’ opinions played a secondary role in most participants’ decision-making about fertility preservation. If embryo cryopreservation was the selected option, partners would have a say because they were involved with their genetic material. Conclusions The findings that emerged from data analysis were partly consistent with prior literature. However, we identified some interesting nuances that are of clinical importance. The results of this study may serve as a starting point for future research.