Objective — to characterize endometrial structural and functional state and receptivity in women with hysteromyoma (HM) and chronic endometritis (CE) in infertile couples. Subject and methods. A total of 130 patients who had HM and/or CE in an infertile couple were examined. Group 1 included 64 women with HM and CE; Group 2 consisted of 24 patients with HM; group 3 comprised 42 patients with EC. A control group included endometrial biopsy specimens from 20 healthy women planning a pregnancy. Results. Patients with HM and CE were found to develop endometrial dysfunction. Its structural signs were damage to the endometrial surface epithelium; intense stromal fibrosis with the high expression of type III and IV collagens; dysregulated processes of high angiogenesis; impaired maturation of pinopodia by the implantation window; high estrogen receptor (ER) expression in the nuclei of endometrial glandular and stromal cells; low progesterone receptor (PR) expression; and impaired secretory endometrial transformation. Conclusion. HM concurrent with CE is responsible for endometrial dysfunction. Its structural manifestations are mainly associated with CE.