Which is the definitive treatment for moderate-sized uterine fibroids in a young woman who desires fertility?

• A. Myomectomy
• B. Hysterectomy
• C. GnRH agonists
• D. Oral progesterone

Answer: (A)

Fertility preservation with definitive management is achieved by removing the fibroids while keeping the uterus intact. Myomectomy accomplishes this by excising the fibroids but leaving the uterine structure in place, allowing future pregnancy. In contrast, hysterectomy permanently eliminates fertility by removing the uterus. Medications like GnRH agonists can shrink fibroids temporarily and help with symptoms or reduce size before surgery, but they are not curative—fibroids often grow back after stopping treatment. Oral progesterone is not an effective solution for eradicating fibroids and is not used to preserve fertility. So, the best option for a young woman desiring future fertility is removing the fibroids via myomectomy.