A 38-year-old woman presents with menorrhagia and dysmenorrhea for 18 months. On examination, the uterus is enlarged to 12 weeks size with irregular contours. Transvaginal ultrasound confirms multiple intramural fibroids, the largest being 4 cm, with no submucosal component. She desires future fertility and wishes to preserve her uterus. What is the most appropriate next step in management?