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Peer-reviewedCC BY-NCDrug design, development and therapy

Comparative Analysis of Progestin Intervention for Non-Atypical Endometrial Hyperplasia in Infertile Females with Anovulation: A Retrospective Study.

  • Xinyu Zhang1,2,3,4,5
  • Zhaowen Xu1,2,3,4,5
  • Yang Wang1,2,3,4,5
  • Ran Li6
  • Xi Du1,2,3,4,5
  • Ningning Pan1,2,3,4,5
  • Caihong Ma1,2,3,4,5
6 affiliations
  1. 1Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China.
  2. 2National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China.
  3. 3Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing, People's Republic of China.
  4. 4Beijing Key Laboratory of Collaborative Innovation in Frontier Technologies for Population Quality, Peking University Third Hospital, Beijing, People's Republic of China.
  5. 5State Key Laboratory of Female Fertility Promotion, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China.
  6. 6School of Basic Medical Sciences,Peking University Health Science Center, Beijing, People's Republic of China.
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Abstract

Objective

To compare the efficacy of progestin intervention for non-atypical endometrial hyperplasia (non-atypical EH) in infertile patients with ovulatory dysfunction, and to explore factors associated with histological regression.Methods

A retrospective cohort study was conducted at a tertiary reproductive medicine center. A total of 171 infertile females with anovulation diagnosed with non-atypical EH by hysteroscopic biopsy between March 2021 and August 2024 were enrolled. Patients were divided into polycystic ovary syndrome (PCOS) group (n=89) and diminished ovarian reserve (DOR) group (n=82) according to ovarian reserve function. All patients received 3-month oral progestin therapy. The study aims to analyze and compare the regression of endometrial hyperplasia after 3 months of treatment. Multivariate logistic regression was used to analyze independent factors affecting treatment response.Results

After progestin treatment, the overall EH regression rate was 82.46%, with no significant difference between the DOR group (84.15%) and PCOS group (80.90%) (P=0.577). In the DOR subgroup, high-potency progestins achieved a significantly higher regression rate than dydrogesterone (89.83% vs 69.57%, P=0.040), while no such difference was found in the PCOS group (P=0.527). The clinical pregnancy rate (31.71% vs 48.31%, P=0.027) and live birth rate (14.63% vs 38.20%, P<0.001) were significantly lower in the DOR group. But no significant association was observed between progestin type and clinical pregnancy (P = 0.097, OR = 0.586, 95% CI 0.312-1.101).Multivariate analysis revealed that lower body mass index (BMI) (OR=0.893, 95% CI: 0.809-0.985, P=0.024) and high-potency progestin regimen (OR=2.913, 95% CI: 1.147-7.400, P=0.025) were independent protective factors for EH regression.Conclusion

Progestin provides comparable histological regression for non-atypical EH in infertile females with anovulation. A potential benefit of high-potency progestins was observed among patients with DOR.

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Cite

BibTeXRIS
BibTeX
@article{zhang2026comparative,
  title = {{Comparative Analysis of Progestin Intervention for Non-Atypical Endometrial Hyperplasia in Infertile Females with Anovulation: A Retrospective Study.}},
  author = {Xinyu Zhang and Zhaowen Xu and Yang Wang and Ran Li and Xi Du and Ningning Pan and Caihong Ma},
  journal = {Drug design, development and therapy},
  year = {2026},
  month = oct,
  doi = {10.2147/dddt.s634398},
  url = {https://europepmc.org/article/MED/42903837},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Comparative Analysis of Progestin Intervention for Non-Atypical Endometrial Hyperplasia in Infertile Females with Anovulation: A Retrospective Study.
AU  - Xinyu Zhang
AU  - Zhaowen Xu
AU  - Yang Wang
AU  - Ran Li
AU  - Xi Du
AU  - Ningning Pan
AU  - Caihong Ma
PY  - 2026
DA  - 2026/10/16
JO  - Drug design, development and therapy
DO  - 10.2147/dddt.s634398
UR  - https://europepmc.org/article/MED/42903837
AB  - Objective  To compare the efficacy of progestin intervention for non-atypical endometrial hyperplasia (non-atypical EH) in infertile patients with ovulatory dysfunction, and to explore factors associated with histological regression.Methods  A retrospective cohort study was conducted at a tertiary reproductive medicine center. A total of 171 infertile females with anovulation diagnosed with non-atypical EH by hysteroscopic biopsy between March 2021 and August 2024 were enrolled. Patients were divided into polycystic ovary syndrome (PCOS) group (n=89) and diminished ovarian reserve (DOR) group (n=82) according to ovarian reserve function. All patients received 3-month oral progestin therapy. The study aims to analyze and compare the regression of endometrial hyperplasia after 3 months of treatment. Multivariate logistic regression was used to analyze independent factors affecting treatment response.Results  After progestin treatment, the overall EH regression rate was 82.46%, with no significant difference between the DOR group (84.15%) and PCOS group (80.90%) (P=0.577). In the DOR subgroup, high-potency progestins achieved a significantly higher regression rate than dydrogesterone (89.83% vs 69.57%, P=0.040), while no such difference was found in the PCOS group (P=0.527). The clinical pregnancy rate (31.71% vs 48.31%, P=0.027) and live birth rate (14.63% vs 38.20%, P<0.001) were significantly lower in the DOR group. But no significant association was observed between progestin type and clinical pregnancy (P = 0.097, OR = 0.586, 95% CI 0.312-1.101).Multivariate analysis revealed that lower body mass index (BMI) (OR=0.893, 95% CI: 0.809-0.985, P=0.024) and high-potency progestin regimen (OR=2.913, 95% CI: 1.147-7.400, P=0.025) were independent protective factors for EH regression.Conclusion  Progestin provides comparable histological regression for non-atypical EH in infertile females with anovulation. A potential benefit of high-potency progestins was observed among patients with DOR.
SN  - 1177-8881
ER  -