To examine whether demographic and cancer-related characteristics and factors such as fertility discussion with a medical provider and fertility preservation use are associated with attempting pregnancy after adolescent and young adult cancer.Cross-sectional online survey SUBJECTS: Women with lymphoma, breast cancer, thyroid cancer, or gynecologic cancer diagnosed at ages 15-39 years during 2004-2016 were identified from the North Carolina Cancer Registry and the Kaiser Permanente Northern and Southern California healthcare systems and responded to an online survey addressing survivorship concerns, including fertility and reproductive outcomes.Demographic characteristics, cancer characteristics, fertility discussion with a medical provider or fertility specialist between cancer diagnosis and starting cancer treatment, use of fertility preservation strategies (freezing embryos or oocytes) after cancer diagnosis MAIN OUTCOME MEASURES: Pregnancy attempt after cancer diagnosis, defined by either a pregnancy or 12 months of trying to become pregnant without pregnancy RESULTS: Among 801 participants who had not reached their desired family size at diagnosis, 77% had a fertility discussion with any medical provider between cancer diagnosis and starting treatment and 8% used fertility preservation after cancer diagnosis. At survey (median=7 years post-diagnosis; IQR=4-10), 32% had attempted pregnancy. Neither fertility discussion with any medical provider nor fertility counseling with a fertility specialist was significantly associated with pregnancy attempts. However, use of fertility preservation was significantly associated with attempting pregnancy (PR=1.74; 95% CI: 1.31-2.32). Other characteristics positively associated with pregnancy attempts included younger age at diagnosis, longer time since diagnosis, having a partner (at diagnosis or at survey), and having a history of infertility prior to cancer diagnosis.Use of fertility preservation strategies was uncommon in our cohort but was associated with attempting pregnancy after cancer. Ensuring access to fertility preservation methods may help adolescent and young adult cancer survivors to plan and initiate future fertility.