Background: Uterine fibroids are a common gynecological condition that may cause heavy menstrual bleeding, pelvic pain, and pressure on the nearby organs. Uterine artery embolization is a minimally invasive treatment that offers an alternative to myomectomy or hysterectomy. The procedure works by occluding the uterine arteries and reducing blood flow to the fibroids, which leads to ischemia and gradual shrinkage, thereby relieving the symptoms.

Objectives: To evaluate the effectiveness of uterine artery embolization in reducing the size of the uterine fibroids and alleviating the associated symptoms, and to compare treatment outcomes between International Federation of Gynaecology and Obstetrics FIGO 0–3 and 4–7 groups according to the FIGO classifications of uterine fibroids.

Methods: This prospective comparative study, conducted at the Baghdad Teaching Hospital from December 4, 2023, to December 22, 2024, involved 20 patients with symptomatic uterine fibroids who underwent uterine artery embolization. Ultrasounds were performed prior to, and three months and six months after the procedure, to evaluate the fibroid volume, the largest fibroid diameter, volume reduction rate, symptom improvement, and adverse events. The volume reduction rates of the two groups were compared, based on the fibroid classification (Group A: FIGO 0-3 and Group B: FIGO 4-7) at three and six months.

Results: Of the 20 women included in the study, 90% were over the age of 35 years and 65% were obese. Following uterine artery embolization, menorrhagia decreased from 90% to 40%, intermenstrual bleeding from 45% to 5%, and dysmenorrhea from 65% to 30%. Radiologically, the mean fibroid volume reduction at six months was significantly higher in the FIGO 0–3 group (93.7%, p=0.006) compared to the FIGO 4–7 group (26.0%, p=0.002).

Conclusions: Uterine artery embolization is an effective procedure that significantly reduces fibroid size and improves its symptoms; the reduction in the largest fibroid diameter was more pronounced in the FIGO 0–3 group than in the FIGO 4–7 group.