The cause of excessive bleeding seems to be because of the fibroids or it may be because of ovarian cyst
. But one important differential diagnosis of fibroid on USG is adenomyoma
specially when it is in the posterior wall of uterus
as it is in your case and also in your age group. So you need a perfect diagnosis which can be achieved by MRI Pelvis.
In ovarian cyst there is lower abdominal pain
and other symptoms as well about which you have not mentioned anything. So its difficult to comment on that.
CA 125 is tricky. Apart from malignant conditions it is raised in many non malignant conditions as well. But still the malignant conditions are to ruled out specially when the value is 192.50.
You have not completed your family so special consideration has to be given. Consult an experienced radiologist
to confirm the diagnosis and then and a gynecologist to construct further work up.
You can contact again in this regard.