Uterine Fibroid Embolization

A 45-year-old, premenopausal black woman (gravida 3, para 2, with a history of one spontaneous abortion) presents with menorrhagia and dysmenorrhea that has worsened progressively over a period of 10 years. She does not wish to have any more children. On physical examination, she has a firm, nontender, enlarged uterus. The ovaries are not palpable. Laboratory tests in the past had revealed intermittent mild anemia that was correctable with iron supplementation, but more severe anemia has been noted recently, and she has had increasing difficulty managing her menstrual bleeding. In-office ultrasound examinations have shown several intramural uterine masses consistent with uterine fibroids that have been slowly increasing in size; the largest measures 6.5 cm at the point of its greatest dimension. The adnexa are normal. The patient's gynecologist has recommended a hysterectomy. However, the patient does not want to undergo a hysterectomy, and her gynecologist suggests uterine fibroid embolization as an alternative. She is referred to an interventional radiologist who orders a magnetic resonance imaging (MRI) scan. The results of the MRI confirm the ultrasound findings and rule out adenomyosis. The interventional radiologist discusses with the patient uterine fibroid embolization as an alternative to hysterectomy. What treatment should be recommended for this patient?