Patients receiving treatment that has the potential to negatively affect their gonads, including chemotherapy, surgery, and radiation therapy, should be informed of options for fertility preservation and future reproduction before initiating treatment. Reproduction in the context of fertility-affecting treatment raises a number of ethical issues related to the welfare of both patients and offspring. This document replaces the document titled, "Fertility preservation and reproduction in patients facing gonadotoxic therapies: an Ethics Committee opinion," last published in 2018. (Fertil Steril (R) 2026;125:260-6. (c) 2025 by American Society for Reproductive Medicine.) El resumen est & aacute; disponible en Espa & ntilde;ol al final del art & iacute;culo.