Is there a role for radiofrequency and assisted reproductive technology?

Purpose of review 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.