Do I have to have a hysterectomy?

When you get a second opinion, ask about uterine artery embolization. That might be an option for you. Ablation wont' work because it destroys the uterine lining. But you have a fibroid in the muscle, so that won't be affected by the ablation.

You don't have a "perfectly healthy" uterus as that other woman claimed--having a fibroid means it's not "perfectly healthy." Nevertheless, there are other options beyond simply hysterectomy. That's the easiest thing for THE DOCTOR to do. Not the easiest or necessarily best for the patient. More skilled docs might present more options. Good luck!

Four centimeters is not that large. Is the fibroid causing you to have any discomfort or interfering with your lifestyle (heavy periods, painful cramps, nausea during your monthly cycle, etc.)? I would ask for a referral to another gynecologist for a second opinion. Ablation may not work since your gynecologist has told you the fibroid is "half way into the uterine muscle". However, there may be other alternatives to the hysterectomy.

Follow your gut instinct. I would sure wait for an ultrasound or MRI.