Before starting treatment, physicians should ask patients about their post-treatment fertility intentions, and at the time of chemotherapy, drugs with minimal impact on reproductive function should be used as much as possible, guided by the currently available evidence. Among the commonly used chemotherapeutic agents for breast cancer, alkylating agents are generally considered to have definite ovarian toxic effects, which can significantly destroy follicles and lead to ovarian failure. The effects of anthracyclines, fluorouracil, and vincristine on women’s reproduction are relatively minor. Tamoxifen itself does not cause infertility, but its application is not recommended for the time being due to its possible distant fetal teratogenic effects.