Which surgical option preserves fertility in women with uterine fibroids?

• A. Hysterectomy
• B. Endometrial ablation
• C. Oophorectomy
• D. Myomectomy

Answer: (D)

Preserving fertility in women with fibroids means removing the fibroids while keeping the uterus intact. This is achieved with a myomectomy, which excises the fibroid tissue but leaves the uterus and uterine cavity in place, allowing for potential future pregnancies.

Myomectomy can be done in different ways depending on fibroid location and size—for submucosal fibroids near the lining, a hysteroscopic approach may be used; for larger or intramural fibroids, laparoscopic or open approaches may be chosen. While fibroids can recur, the procedure preserves fertility better than removing the uterus.

By comparison, removing the uterus eliminates the possibility of pregnancy. Endometrial ablation targets the lining of the uterus and is not designed to treat fibroids or preserve fertility. Removing the ovaries would stop ovarian hormone production and fertility.