An enlarged uterus with mixed echogenecity implies either a fibroid, which is a non-cancerous tumour of the uterus, or an adenomyosis where the lining of the uterus grows into the muscular wall of the uterus. If this gives unbearable pain or bleeding during the period or if it is a cause of infertility, only then does it need treatment. Only a detailed evaluation of the ultrasound can help us decide if this is against achieving a pregnancy.