Is there a role for radiofrequency and assisted reproductive technology?

Correspondence to María Cerrillo, MD, IVIRMA Madrid Global Research Alliance, Av Talgo 68, CP 28023, Madrid, Spain, Tel: +34 911 809 000; e-mail: [email protected] Current Opinion in Obstetrics and Gynecology 38(3):p 147-153, June 2026. | DOI: 10.1097/GCO.0000000000001097 The purpose of this study is to review the current evidence on the efficacy and safety of transvaginal radiofrequency ablation (TRFA) for the treatment of uterine fibroids and adenomyosis in infertile women, and to assess its feasibility as a fertility-preserving alternative to myomectomy. Recent findings TRFA induces coagulative necrosis of fibroid tissue, achieving a 60–70% reduction in fibroid volume within 1 year while preserving uterine anatomy. Recent studies report pregnancy rates comparable to those of the general population, achieved through both spontaneous conception and assisted reproductive techniques. Large clinical series show no cases of uterine rupture or major obstetric complications attributable to the procedure. Initial fibroid volume appears to be a key determinant of time to conception, with larger fibroids requiring longer resorption periods. Summary TRFA is a safe, minimally invasive technique that preserves uterine integrity and offers obstetric outcomes comparable to those of the general population. It represents an effective option to optimize the uterine environment prior to pregnancy, particularly in women with intramural fibroids. Plain Language SummaryThis review examined how effective and safe transvaginal radiofrequency ablation (TRFA) is for treating uterine fibroids and adenomyosis in infertile women, and whether it can serve as a fertility-preserving alternative to myomectomy. TRFA works by inducing coagulative necrosis in fibroid tissue and achieves about a 60–70% reduction in fibroid volume within 1 year while maintaining uterine anatomy. Reported pregnancy rates, via both spontaneous conception and assisted reproductive techniques, are similar to those of the general population, with no uterine ruptures or major obstetric complications linked to TRFA. Larger initial fibroid volume may delay conception, but overall TRFA offers a safe, minimally invasive option to optimize the uterus before pregnancy, especially in women with intramural fibroids. Text is machine generated and may contain inaccuracies. FAQ