Table 3.

Non-surgical management of uterine fibroids

Treatment	Evidence-based recommendation
Uterine artery embolization	Minimally invasive; reduces symptoms and decreases fibroid volume by limiting blood supply to the fibroids as non-involved uterus is spared; recommended for patients who are not good surgical candidates or who choose to avoid surgery; may impact uterine and ovarian function; impact on fertility requires further investigation [31, 41, 46]
MRI-guided-focused ultrasound	Minimally invasive yet effective for controlling symptoms and reducing fibroid size; recommended for patients who are not good surgical candidates or who choose to avoid surgery; impact on fertility requires further investigation [31, 41, 46]
Ultrasound-guided, high-intensity-focused ultrasound ablation	Reduces fibroid symptoms and decreases fibroid and uterine volume with no reported permanent adverse effects [61]
Transcervical radiofrequency ablation	Minimally invasive; uses radiofrequency energy to ablate fibroids; not yet included in treatment guidelines [62]

MRI, magnetic resonance imaging