Real-life experience with transvaginal radiofrequency ablation in infertile patients with types 2 and 3 fibroids

Transvaginal radiofrequency ablation (TRFA) may offer a safe and effective alternative to surgery for infertile women with type 2 or 3 fibroids under 4 cm diameter that compromise the uterine cavity.

In this study, 36 patients underwent ultrasound-guided TRFA between 2020 and 2023. Main outcomes were fibroid volume reduction at 1, 3, and 6 months, and post-procedure reproductive results.

Mean baseline fibroid volume was 19.29 cm³, decreasing to 9.6 cm³ at 1 month, 4.39 cm³ at 3 months, and 4.07 cm³ at 6 months, reflecting >75% reduction. Mild pain and minimal bleeding occurred in 22% of patients; hysteroscopic removal of protruding fibroids was required in 22%. Among the 25 women undergoing subsequent ART, pregnancy and miscarriage rates per treated patient were 68% and 16%, respectively; live births occurred in 52%, with most deliveries at full-term. Caesarean delivery rate was 69.2%.

TRFA appears to be a safe and effective alternative to surgery for infertile women with type 2 or 3 fibroids under 4 cm in diameter that compromise the uterine cavity. The procedure does not seem to affect reproductive outcomes, and this study is the first to assess the effect of TRFA on ART.