There are several disorders that may turn the uterus into a hostile environment for a pregnancy.

Among these we can find congenital uterine malformations, such as a uterine septum or a bicornuate uterus and other problems linked to its shape, to fibroids,  polyps or intrauterine adhesions. All these factors may reduce the endometrial receptivity.

The transport and preparation of the sperm through the cervix may also be affected. Common causes include hormonal, infectious, immunological or surgical (curettages and conization) factors.

Investigations to check for uterine abnormalities typically include an ultrasound, a hysterosalpingogram and a laparoscopy and hysteroscopy.

The normal anatomy of the uterus can be studied by ultrasound, Histerosalpingography, laparoscopy and hysteroscopy.

On occasions, there may be structural defects, biochemical or functional oocytes that reduce their ability to be fertilized.