OBJECTIVE To introduce the importance of oncofertility and fertility preservation counseling in women with breast cancer and to discuss possible impacting factors regarding Iranian breast cancer female patients’ participation in fertility preservation programs. METHODS In this study, 146 females with breast cancer were studied. The eligibility criteria were: female patients with breast cancer, to be in their reproductive age (between 14 to 45 years). Patients with at least one of the following criteria were excluded from this study: Having received chemo-radiotherapy before the current treatment, having received hormonal or pharmacological assisted reproductive treatments previously and unwillingness to participate in this study. RESULTS Out of 146 patients, oncofertility counseling was requested for 55 eligible patients. Oocyte-egg cryopreservation was successful in 16 patients (29.10%). In four patients (7.27%), the number of ovarian follicles was inadequate. For 10 patients (18.18%), oncologists advised initiation of chemotherapy before completion of preservation programs, and 25 patients (45.45%) decided not to continue their preservation programs. Out of 91 patients not receiving oncofertility counseling, 76 patients (83.50%) declared that their family planning was completed, 11 patients (12.10%) were in the early stages of breast cancer and did not require chemoradiotherapy, and four patients (4.40%) were in metastatic stages. We also found that contrary to the number of living children of patients, neither age nor marital status has an impact on their decisions to participate in fertility preservation programs. CONCLUSION To improve the quality of lives of Iranian women suffering from breast cancer, it is of utmost importance to raise awareness of oncofertility and to investigate the reasons for the under-implementation of fertility preservation programs in cancer patients.