Uterine myoma (UM) is the most common benign tumor of the uterus and it occurs in 20-40% of reproductiveaged women, which substantially diminishes female reproductive function. UM has been still treated surgically so far and it is the most common reason for hysterectomy. Subjects and methods. The study included 234 patients aged 29–45 years with symptomatic UM who planned pregnancy and received the selective progesterone receptor modulator ulipristal acetate 5 mg for 3 months. Surgical treatment was planned for the women. Results. In 141 (60.3%) women, amenorrhea occurred during 7–9 days. After treatment, there was an obvious reduction in anemia (mild anemia in 108 (46.2%) women; a normal hemoglobin level in 126 (53.8%) women; p > 0.05). The mean decrease in uterine sizes was 30.7% (minimum 8% from 425 to 391 cm³; maximum 78%, from 1282 to 282 cm³); UM was reduced by 27.8% (minimum 12%, from 285 to 251 cm³; maximum 55%, from 949 to 427 cm³). In 54 (23.1%) women, the sizes of the uterus and myomatous nodules were unchanged. Laparoscopy, myomectomy were successfully performed in 216 (92.3%) patients. Surgery could be avoided in 18 (7.7%) patients after cycle therapy (p > 0.05). Conclusion. The innovative approach to using ulipristal acetate led to substantial UM regression, which permitted surgical treatment with a minimal impact on the uterine cavity, improving a reproductive prognosis.