Uterine fibroids are the most common benign gynecological tumors. There is a consensus that surgery is not necessary for women without fertility requirements and without symptoms, that is, treatment is required only if there is excessive menstruation, anemia, or an enlarged uterus causing urinary frequency and urgency, abdominal pain, or discomfort. However, for women with fertility requirements and clear symptoms, they also need to be treated separately according to the severity of the symptoms: if the symptoms are mild, patients are advised to actively prepare for pregnancy for 6 months. If the preparation is unsuccessful, an infertility-related evaluation is required. If no other infertility factors are present, minimally invasive debridement of the fibroids may be considered. If the symptoms are more severe, it is more important to consult with the surgeon about the impact on fertility and choose the appropriate treatment plan. Regarding the choice of surgical procedure, submucosal fibroids may alter the volume of the uterine cavity, interfere with implantation and increase the risk of pregnancy; hysteroscopic excision should be considered whenever possible. Subplasmalemmal fibroids have little effect on pregnancy and the surgery can be left alone. Interstitial myomas may be a high risk factor for infertility and increase pregnancy complications including miscarriage. If the size of the myoma exceeds 125px, a better result may be achieved with laparoscopic surgery.