Accepted Article This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/ijgo.12868 This article is protected by copyright. All rights reserved. REVIEW A systematic review and meta-analysis of ulipristal acetate for symptomatic uterine fibroids Mohamed Ghonim 1,2 , Rana Magdy 1,2 , Mohamed Sabbour 1,2 , Mohanad Ghonim 1,2 , Ashraf Nabhan 2,3,* 1 Extended Modular Program, Faculty of Medicine, Ain Shams University, Cairo, Egypt 2 Egyptian Center for Evidence Based Medicine, Cairo, Egypt 3 Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt *Corresponding author: Ashraf Nabhan El-Khalifa El Maamoun Street, Cairo, Egypt 11351. Email address: anabhan@med.asu.edu.eg Keywords: Amenorrhea; Health-related quality of life; Leiomyoma; Menorrhagia; Systematic review; Ulipristal acetate; Uterine fibroids Synopsis: Compared with placebo, oral ulipristal acetate induces amenorrhea, reduces heavy menses, and improves quality-of-life symptom severity in women with uterine fibroids. ABSTRACT Background: Uterine fibroids cause menorrhagia and adversely affect quality of life. Ulipristal acetate (UPA) can improve fibroid symptoms. Objectives: To assess the effectiveness of UPA in women with symptomatic uterine fibroids.