The uterus must be normally shaped and free of obstructions to support a developing fetus. Large fibroids or polyps can make implantation and fetal development difficult. Your physician will investigate the uterine cavity using ultrasound techniques or hysterosalpingogram to be sure that fibroids and polyps are not present.
Some women are born with a uterine structural abnormality such as a bicornuate uterus (two horned). A bicornuate uterus does not cause infertility but it does increase the chances of miscarriage and can cause problems during pregnancy. A septate uterus is another example of a structural abnormality causing repeat pregnancy loss. Pelvic inflammatory disease, usually caused by infection, can damage the uterus by causing scar tissue within or outside of the uterus. Polyps and fibroids can often be removed, and some structural abnormalities, such as septate uterus can be corrected surgically.
As long as a woman's uterus is normal she can carry children even after the menopause using embryos from a donor egg IVF cycle.