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All the patients were followed up at least 12\u00a0months, and asked about the follow-up treatment plan, review, pregnancy and reproductive outcome of the patients with reproductive needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Obesity (P\u2009=\u20090.044), having diabetes or insulin resistance (P\u2009=\u20090.032) and polycystic ovary syndrome (PCOS) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) are risk factors for the occurrence of CH, while gravidity\u2009\u2265\u20091 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.045) is a protective factor for the occurrence of CH. Compared with the SH group, the reversal rate in the CH group was significantly lower (69.7% vs 83.6%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), while the rate of persistence, progression, recurrence and canceration were higher (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Compared with no treatment, oral progesterone (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and levonorgestrel-releasing intrauterine system (LNG-IUS) treatment (P\u2009&lt;\u20090.001) could improve the prognosis of patients with EH. The live birth rate of the CH group was obviously lower than that of the SH group ( 42.3% VS 61.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.038). CH (OR\u2009=\u20092.68, 95%CI 1.12\u20136.39,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.043) is an independent risk factor affecting the live birth rate of patients with EH.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Obesity, diabetes, insulin resistance, PCOS and nulligravidity are risk factors for patients with EH, while gravidity\u2009\u2265\u20091 served as a protective factor, particularly against CH. The type of hyperplasia is associated with a low live birth rate. The prognosis of EH patients is usually poor, with a low reversal rate and a long reversal time. However, LNG-IUS can improve their prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-026-08356-9","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T13:06:01Z","timestamp":1770815161000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics, prognosis, and fertility outcomes in patients with simple and complex endometrial hyperplasia: a comparative analysis"],"prefix":"10.1007","volume":"313","author":[{"given":"Jiayu","family":"Wei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haiyun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingmei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenyan","family":"Tian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5013-7142","authenticated-orcid":false,"given":"Huiying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"issue":"2","key":"8356_CR1","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1093\/humupd\/dmw042","volume":"23","author":"PA Sanderson","year":"2017","unstructured":"Sanderson PA, Critchley HOD, Williams ARW, Arends MJ, Saunders PTK (2017) New concepts for an old problem: the diagnosis of endometrial hyperplasia. 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The studies involving human participants were reviewed and approved by The Committee for Medical Research Ethics at Tianjin Medical University General Hospital (Ethical No. IRB2025-YX-264\u201301). The patients provided their written informed consent to participate in this study. Written informed consent was obtained from the individuals for the publication of any potentially identifiable images or data included in this article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}],"article-number":"87"}}