Abstract Fertility preservation has emerged as a crucial theme for oncologic patients due to improving survival rates. Nowadays, both Oncology and Reproductive Medicine societies recommend informing all reproductive-aged cancer patients about potential fertility loss and an early referral to infertility specialists. Ovarian tumours are particularly challenging as they affect the organ to be preserved. Fertility preservation techniques like oocyte-freezing and ovarian tissue cryopreservation can be considered. Shared decision-making involving comprehensive risk-benefit discussions, in a multidisciplinary setting, is imperative for personalized approaches to fertility preservation. In conclusion, proactive fertility preservation counselling and tailored strategies, considering tumour characteristics and patient preferences are vital for optimizing outcomes in women with ovarian tumours.