Uterine Fibroids

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Focused ultrasound treatment for uterine fibroids has been available to women in the U.S. since a treatment system was approved by the Food and Drug Administration (FDA) in 2004.

Focused ultrasound is a noninvasive way to treat uterine fibroids. Using this treatment method in conjunction with image guidance, the physician directs a focused beam of energy through the patient’s skin, superficial fat layer, and abdominal muscles to heat and destroy the fibroid tissue without damaging nearby tissue or the tissues that the beam passes through on its way to the target.

How it Works
Focused ultrasound energy heats and destroys the targeted tissue at the focal point. This process is repeated until the entire selected volume is destroyed.


  • It is a noninvasive treatment with a short recovery time and a quick return to work and activities of normal life (usually the next day).
  • It offers rapid and durable resolution of fibroid symptoms (sometimes within days of treatment).
  • It has a low rate of complications.
  • It preserves fertility with published studies reporting that women are able to conceive and have normal pregnancies after treatment.

Get Treated

There is a clinical trial in China that is treating adenomyosis in patients with refractory infertility with the goal of enhancing fertility.

There is a clinical trial in the Netherlands, which is a 2:1 randomized trial comparing MRI-guided focused ultrasound to other treatments (hysterectomy, myomectomy, or uterine artery ablation). See the website for this trial, called MYCHOICE, for more information. 

There is a clinical trial in Germany, that is a randomized trial comparing MRI-guided focused ultrasound to myomectomy.

There is a clinical trial in France that exploring fibroid elasticity and diffusion to assess how those factors predict success in focused ultrasound ablation of uterine fibroids.

There is a clinical trial in Turku, Finland, that is using focused ultrasound to treat uterine fibroids.

There is a clinical trial in Canada using MRI-guided focused ultrasound to treat uterine leiomyomas. This trial is only open to Canadian citizens.

See a list of treatment sites > 
See a list of clinical trials sites >
See a list of laboratory research sites >

Regulatory Approval and Reimbursement

In 2004, MRI-guided focused ultrasound was approved by US Food and Drug Administration for the treatment of uterine fibroids. Currently, no major U.S. insurance company provides consistent coverage and reimbursement for focused ultrasound treatment of fibroids. However, Blue Cross/Blue Shield, AETNA, and United have all approved cases on an individual basis.

Internationally, focused ultrasound is approved in Canada, China, Europe, India, Japan, Korea, the Middle East, Oceania, Russia, South America, and Taiwan. 

In the United Kingdom, Germany, and Russia, individual patients have gained local level approval. In China, healthcare insurance partially or fully covers the cost of the treatment. 

In Israel, Clalit Medical Insurance is covering MRgFUS for symptomatic uterine fibroids.

Notable Papers

Chen Y, Zhao F, Feng L, Zhou F, Zhou X. Evaluating the Effects of Water Balloons on High-Intensity Focused Ultrasound for Treating Uterine Fibroids. Ultrasound Med Biol. 2024 Feb 14:S0301-5629(24)00027-9. doi: 10.1016/j.ultrasmedbio.2024.01.013. PMID: 38360493 

Cheng Y, Yang L, Wang Y, Kuang L, Pan X, Chen L, Cao X, Xu Y. Development and validation of a radiomics model based on T2-weighted imaging for predicting the efficacy of high intensity focused ultrasound ablation in uterine fibroids. Quant Imaging Med Surg. 2024 Feb 1;14(2):1803-1819. doi: 10.21037/qims-23-916. Epub 2024 Jan 22. PMID: 38415139 

Cui Y, Zhang J, Rao J, Feng M, Yao L, Liao W, Liang C, Huang Y. MR Diffusion-Weighted Imaging in Evaluating Immediate HIFU Treatment Response of Uterine Fibroids. Curr Med Imaging. 2024 Feb 27. doi: 10.2174/0115734056270504231218072151. PMID: 38415459 

Laganà AS, Romano A, Vanhie A, Bafort C, Götte M, Aaltonen LA, Mas A, De Bruyn C, Van den Bosch T, Coosemans A, Guerriero S, Haimovich S, Tanos V, Bongers M, Barra F, Al-Hendy A, Chiantera V, Leone Roberti Maggiore U. Management of Uterine Fibroids and Sarcomas: the Palermo Position Paper. Gynecol Obstet Invest. 2024 Feb 21. doi: 10.1159/000537730. PMID: 38382486 

Li S, Ma WW, Yang MJ, Deng YB, Hu L, Chen JY. Long-term re-intervention after USgHIFU and prediction of NPVR in different ages of patients with uterine fibroids. Int J Hyperthermia. 2024;41(1):2304264. doi: 10.1080/02656736.2024.2304264. Epub 2024 Jan 23. PMID: 38258583 

Yan W, Yuan S, Zhou D, Zhang M, Yang S, Wang W, Wang S. Status and treatment of patients with uterine fibroids in hospitals in central China: a retrospective study from 2018 to 2021. BMJ Open. 2024 Jan 17;14(1):e081736. doi: 10.1136/bmjopen-2023-081736. PMID: 38233053 

Park SA, Lee J, Kim HY. Virtual reality education program for women with uterine tumors treated by high-intensity focused ultrasound. Heliyon. 2023 Dec 16;10(1):e23759. doi: 10.1016/j.heliyon.2023.e23759. eCollection 2024 Jan 15. PMID: 38226233 

Liu Y, Lv F, Liu Y, Zhong Y, Qin Y, Lv F, Xiao Z. Factors influencing magnetic resonance imaging changes associated with pelvic bone injury after high-intensity focused ultrasound ablation of uterine fibroids: a retrospective case-control study. Quant Imaging Med Surg. 2024 Jan 3;14(1):179-193. doi: 10.21037/qims-23-323. Epub 2024 Jan 2. PMID: 38223045 

Dou Y, Zhang L, Liu Y, He M, Wang Y, Wang Z. Long-term outcome and risk factors of reintervention after high intensity focused ultrasound ablation for uterine fibroids: a systematic review and meta-analysis. Int J Hyperthermia. 2024;41(1):2299479. doi: 10.1080/02656736.2023.2299479. Epub 2024 Jan 2. PMID: 38164630 

Chendian T, Guohua H, Wang Z, Fang L, Luo S, Liu X, Shi Q. Factors associated with thermal injury of abdominal skin in focused ultrasound ablation of uterine fibroids. Int J Hyperthermia. 2024;41(1):2295232. doi: 10.1080/02656736.2023.2295232. Epub 2023 Dec 30. PMID: 38159557 

Zhou Y, Zhang J, Li C, Chen J, Lv F, Deng Y, Chen S, Du Y, Li F. Prediction of non-perfusion volume ratio for uterine fibroids treated with ultrasound-guided high-intensity focused ultrasound based on MRI radiomics combined with clinical parameters. Biomed Eng Online. 2023 Dec 13;22(1):123. doi: 10.1186/s12938-023-01182-z. PMID: 38093245 

Capezzuoli T, Aslan B, Vannuccini S, Orlandi G, La Torre F, Sorbi F, Fambrini M, Petraglia F. Recurrence of Uterine Fibroids After Conservative Surgery or Radiological Procedures: a Narrative Review. Reprod Sci. 2023 Dec 18. doi: 10.1007/s43032-023-01418-2. PMID: 38110820 

Zhou Y, Chen P, Ji X, Sun T, Li Y, Yuan J, Chen Y, Xiong Y, Wang Y. Long-term Efficacy of Fibroid Devascularization with Ultrasound-Guided High-Intensity Focused Ultrasound. Acad Radiol. 2023 Nov 16:S1076-6332(23)00599-8. doi: 10.1016/j.acra.2023.10.045. PMID: 37980220 

Tang NH, Fang CL, Hu WH, Tian L, Lin C, Hu HQ, Shi QL, Xu F. Age-stratified risk factors of re-intervention for uterine fibroids treated with high-intensity focused ultrasound. Int J Gynaecol Obstet. 2023 Nov 12. doi: 10.1002/ijgo.15217. PMID: 37953647 

Jin J, Zhao Y, Huang P. Combination of HIFU with sulfur hexafluoride microbubbles in the treatment of solitary uterine fibroids: a systematic review and meta-analysis. Eur Radiol. 2023 Nov 11. doi: 10.1007/s00330-023-10407-7. PMID: 37950765 

Cañete Palomo ML. Non-surgical techniques for the treatment of uterine fibroids: Uterine artery embolization (UAE), high intensity focused ultrasound (HIFU) and radiofrequency ablation (RFA). [Original Title: Técnicas no quirúrgicas para el tratamiento de los miomas uterinos: embolización de las arterias uterinas (EAU), ultrasonido focalizado de alta intensidad (HIFU) y ablación por radiofrecuencia (ARF).] Med Clin (Barc). 2023 Oct;161 Suppl 1:S27-S31. doi: 10.1016/j.medcli.2023.07.007. PMID: 37923511 

Zhang J, Xu W, Lei C, Pu Y, Zhang Y, Zhang J, Yu H, Su X, Huang Y, Gong R, Zhang L, Shi Q. Using Clinician-Patient WeChat Group Communication Data to Identify Symptom Burdens in Patients With Uterine Fibroids Under Focused Ultrasound Ablation Surgery Treatment: Qualitative Study. JMIR Form Res. 2023 Sep 1;7:e43995. doi: 10.2196/43995. PMID: 37656501 

Matlac DM, Tonguc T, Mutschler N, Recker F, Ramig O, Strunk HM, Dell T, Pieper CC, Coenen M, Fuhrmann C, Vautey O, Egger EK, Küppers J, Conrad R, Essler M, Mustea A, Marinova M. Study Protocol of a Prospective, Monocentric, Single-Arm Study Investigating the Safety and Efficacy of Local Ablation of Symptomatic Uterine Fibroids with US-Guided High-Intensity Focused Ultrasound (HIFU). J Clin Med. 2023 Sep 12;12(18):5926. doi: 10.3390/jcm12185926. PMID: 37762868 

Kociuba J, Łoziński T, Latra K, Korczyńska L, Skowyra A, Zarychta E, Ciebiera M. Occurrence and Risk Factors for Perioperative Treatment Discontinuation during Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU) Therapy in Symptomatic Uterine Fibroids-A Retrospective Case-Control Study. J Clin Med. 2023 Sep 16;12(18):5999. doi: 10.3390/jcm12185999. PMID: 37762939 

Meng B, Liu N, Wang X, Geng Z, Li Q, Xu M. Current status and outlook of minimally invasive treatment for leiomyomas. Ginekol Pol. 2023 Aug 7. doi: 10.5603/GP.a2023.0065. PMID: 37548497 

Bitton RR, Fast A, Vu KN, Lum DA, Chen B, Hesley GK, Raman SS, Matsumoto AH, Price TM, Tempany C, Dhawan N, Dolen E, Kohi M, Fennessey FM, Ghanouni P. What predicts durable symptom relief of uterine fibroids treated with MRI-guided focused ultrasound? A multicenter trial in 8 academic centers. Eur Radiol. 2023 Aug 9. doi: 10.1007/s00330-023-09984-4. PMID: 37553488 

Li H, Tan H. Regarding “Efficacy and Safety of High-intensity Focused Ultrasound Compared with Uterine Artery Embolization in Cesarean Section Pregnancy: A Meta-analysis”. J Minim Invasive Gynecol. 2023 Aug 27:S1553-4650(23)00759-8. doi: 10.1016/j.jmig.2023.07.016. PMID: 37643660 

Wang Z, Chang Y, Li S. Efficacy and Safety of High-intensity Focused Ultrasound Compared with Uterine Artery Embolization in Cesarean Section Pregnancy: A Meta-analysis. J Minim Invasive Gynecol. 2023 Aug 14:S1553-4650(23)00322-9. doi: 10.1016/j.jmig.2023.07.014. PMID: 37586477 

Shi L, Zhang R, Tao S, Yuan X, Zhang J, Wang B, Xiang M, Ren Z, Cai H, Fu C. Efficacy and Safety of Ultrasound-Guided High-Intensity Focused Ultrasound Ablation in Women With Multiple Uterine Fibroids: An Exploratory Study. Ultrasound Med Biol. 2023 Aug 16:S0301-5629(23)00248-X. doi: 10.1016/j.ultrasmedbio.2023.08.001. PMID: 37596155 

David M. Letter to the editor: Römer et al. The significance of transcervical ultrasound-guided radiofrequency ablation in the treatment of symptomatic fibroids: results of an expert consensus from German speaking countries? In the Archives of Gynecology and Obstetrics volume 306, pages 1-6 (2022). Arch Gynecol Obstet. 2023 Sep;308(3):1045. doi: 10.1007/s00404-022-06761-4. Epub 2022 Nov 17. PMID: 36394665 

Li C, He Z, Lv F, Liu Y, Hu Y, Zhang J, Liu H, Ma S, Xiao Z. An interpretable MRI-based radiomics model predicting the prognosis of high-intensity focused ultrasound ablation of uterine fibroids. Insights Imaging. 2023 Jul 19;14(1):129. doi: 10.1186/s13244-023-01445-2. PMID: 37466728 

Liao S, Wang X, Fu N, Huang Y. High-intensity focussed ultrasound and hysteroscopy endo-operative system cold device procedures for treating >4cm diameter FIGO Type 2 uterine myoma and ensuring successful pregnancy. Eur J Contracept Reprod Health Care. 2023 Jun 2:1-4. doi: 10.1080/13625187.2023.2216329. PMID: 37267044 

Morris JM, Liang A, Fleckenstein K, Singh B, Segars J. A Systematic Review of Minimally Invasive Approaches to Uterine Fibroid Treatment for Improving Quality of Life and Fibroid-Associated Symptoms. Reprod Sci. 2023 May;30(5):1495-1505. doi: 10.1007/s43032-022-01120-9. Epub 2022 Nov 18. PMID: 36401073 

Slotman DJ, Bartels LW, Zijlstra A, Verpalen IM, van Osch JAC, Nijholt IM, Heijman E, van ‘t Veer-Ten Kate M, de Boer E, van den Hoed RD, Froeling M, Boomsma MF. Diffusion-weighted MRI with deep learning for visualizing treatment results of MR-guided HIFU ablation of uterine fibroids. Eur Radiol. 2023 Jun;33(6):4178-4188. doi: 10.1007/s00330-022-09294-1. Epub 2022 Dec 6. PMID: 36472702 

Lee S, Stewart EA. New treatment options for nonsurgical management of uterine fibroids. Curr Opin Obstet Gynecol. 2023 May 4. doi: 10.1097/GCO.0000000000000880. PMID: 37144584 

Fan C, Qian Y, Li Z, Li B. Ultrasound-guided microwave, radiofrequency, and high intensity focused ultrasound (HIFU) ablation in treating uterine leiomyoma: A systemic review and meta-analysis of retrospective studies. Biotechnol Genet Eng Rev. 2023 Apr 10:1-15. doi: 10.1080/02648725.2023.2199560.

Leonardo-Pinto JP, Maghsoudlou P, Salazar GM, Clark NV, Koch RM, Ajao MO, Einarsson JI, Rassier SLC. Diagnosis of gynecologic malignancy following treatment of presumed benign fibroid disease with Interventional Radiology procedures: a retrospective cohort study. Fertil Steril. 2023 Mar 3:S0015-0282(23)00171-1. doi: 10.1016/j.fertnstert.2023.02.038.

Akhatova A, Aimagambetova G, Bapayeva G, Laganà AS, Chiantera V, Oppelt P, Sarria-Santamera A, Terzic M. Reproductive and Obstetric Outcomes after UAE, HIFU, and TFA of Uterine Fibroids: Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2023 Mar 2;20(5):4480. doi: 10.3390/ijerph20054480.

Qin SZ, Jiang Y, Wang YL, Liu N, Lin ZY, Jia Q, Fang J, Huang XH. Predicting the efficacy of high-intensity focused ultrasound (HIFU) ablation for uterine leiomyomas based on DTI indicators and imaging features. Abdom Radiol (NY). 2023 Mar 13. doi: 10.1007/s00261-023-03865-6.

Zhang M, Yin C, Jiang J, Chen Y, Wang J, Wang Q, Zeng Y, Zhou H. Application value of contrast-enhanced ultrasonography in the treatment of uterine fibroids by high-intensity focused ultrasound ablation: A retrospective study. J Clin Ultrasound. 2023 Jan;51(1):113-120. doi: 10.1002/jcu.23294. Epub 2022 Aug 30.

Qin S, Jiang Y, Wang F, Tang L, Huang X. Development and validation of a combined model based on dual-sequence MRI radiomics for predicting the efficacy of high-intensity focused ultrasound ablation for hysteromyoma. Int J Hyperthermia. 2023;40(1):2149862. doi: 10.1080/02656736.2022.2149862.

Theis M, Tonguc T, Savchenko O, Nowak S, Block W, Recker F, Essler M, Mustea A, Attenberger U, Marinova M, Sprinkart AM. Deep learning enables automated MRI-based estimation of uterine volume also in patients with uterine fibroids undergoing high-intensity focused ultrasound therapy. Insights Imaging. 2023 Jan 5;14(1):1. doi: 10.1186/s13244-022-01342-0.

Otonkoski S, Sainio T, Mattila S, Blanco Sequieros R, Perheentupa A, Komar G, Joronen K. Magnetic resonance guided high intensity focused ultrasound for uterine fibroids and adenomyosis has no effect on ovarian reserve. Int J Hyperthermia. 2023;40(1):2154575. doi: 10.1080/02656736.2022.2154575.

Li F, Chen J, Yin L, Zeng D, Wang L, Tao H, Wu X, Wei F, Xu F, Shi Q, Lin Z, Wang Z. HIFU as an alternative modality for patients with uterine fibroids who require fertility-sparing treatment. Int J Hyperthermia. 2023;40(1):2155077. doi: 10.1080/02656736.2022.2155077.

Zhang Q, Chen Y, Lai M, Li Y, Li Q, Fu C, Yao Z, Zhang J. Magnetic Resonance Imaging-guided Focused Ultrasound Surgery in a Swine Adenomyosis Model. Acad Radiol. 2023 Jan 7:S1076-6332(22)00639-0. doi: 10.1016/j.acra.2022.11.034.

Zhu H, Ma Q, Dong G, Yang L, Li Y, Song S, Mu Y. Clinical evaluation of high-intensity focused ultrasound ablation combined with mifepristone and levonorgestrel-releasing intrauterine system to treat symptomatic adenomyosis. Int J Hyperthermia. 2023;40(1):2161641. doi: 10.1080/02656736.2022.2161641.

Click here for additional references from PubMed.

Animated treatment video courtesy of Insightec

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