Background <p>One of the greatest concerns for cancer patients of reproductive age is fertility. Numerous studies have demonstrated that patients with cancer lack regular access to fertility preservation information. This study aimed to evaluate awareness of reproductive concerns related to infertility preservation among female cancer patients.</p> Methods <p>A cross‑sectional study was conducted between March and August 2024 at the gynecological oncology unit in collaboration with the assisted reproductive technology unit at Woman’s Health Hospital, Assiut University, Egypt. A purposive sample of 20 women aged 16–40 years with newly diagnosed early‑stage cancer who had not yet initiated treatment and had already received fertility counseling was recruited. Data were collected through structured face‑to‑face interviews via questionnaires covering personal, obstetrical, reproductive, and cancer‑related characteristics, in addition to the Infertility Knowledge Questionnaire, the Reproductive Concerns After Cancer Scale, the Fertility Intention Scale, and the Decisional Conflict Scale. Associations between study variables were examined via appropriate statistical analyses.</p> Results <p>Most women with cancer reported poor knowledge about fertility preservation, high reproductive concerns, strong fertility intentions, and low decisional conflict. Associations were observed between education level, infertility knowledge, and fertility intentions.</p> Conclusion <p>Most female cancer patients reported high reproductive concerns and strong fertility intentions despite limited knowledge about infertility and fertility preservation. Education level and selected obstetrical factors were associated with infertility knowledge, fertility intentions, and reproductive concerns.</p>