Abnormalities of the uterus can cause infertility by interfering with embryo implantation and fetal growth. Uterine factor infertility is relatively uncommon occurring in less than 5 percent of women.

Sometimes a woman is born with a misshapen uterus, such as the bicornuate or horned uterus, which can sometimes be corrected surgically. Large polyps and fibroids can also interfere with fetal growth and are removed usually via a laparoscopy.

Severe pelvic infections (pelvic inflammatory disease, PID) caused by a variety of microorganisms can permanently damage the uterus and tubes. Cancer treatment may also require the removal of the uterus. 

If the uterus is absent or severely damaged the only option is to use the services of a surrogate using in vitro fertilization (IVF). A surrogate is a woman who carries the baby to term and delivery.