The incidence of endometrial cancer is trending younger and is it possible for young patients with a strong desire to preserve their reproductive function. It is generally considered that the following 7 conditions must be met: 1. young <40 years old with no other fertility disorder problems; 2. early stage with highly differentiated tumor; 3. no lymph node metastasis; 4. positive estrogen and progesterone receptors based on scraping pathology; 5. tissue type is endometrioid adenocarcinoma; 6. urgent request of the patient with good follow-up. Preservation of the reproductive function can be considered only if the above conditions are met. However, if the reproductive function is preserved, is it safe and does it allow pregnancy? According to domestic and foreign studies, the conception rate of patients with severe endometrial atypia is higher and can be cured. In contrast, endometrial cancer patients, despite being early stage, highly differentiated, and having good recent results from endocrine therapy, still have a low conception rate, especially a lower rate of full-term pregnancy. Therefore, for patients with severe ACS, preservation of fertility can be considered, while endometrial cancer must be treated with caution.