In this episode, we introduce the REMPA trial, a study from the Japanese Gynecologic Oncology Group evaluating the safety and efficacy of Repeated Medroxyprogesterone Acetate therapy for young patients with recurrent early-stage endometrial cancer or atypical endometrial hyperplasia who wish to preserve fertility. With recurrence rates remaining high after initial hormone therapy, the trial examines whether repeated high-dose medroxyprogesterone acetate can offer a viable, fertility-sparing alternative to total hysterectomy. We discuss the study’s design, and potential implications for global treatment guidelines, offering hope for expanded options in recurrent endometrial cancer care.