The purpose of this study is to compare the anti-fertility effect of fenugreek seeds aqueous (FSA) extract with marketed combined oral contraceptive pills (COCPs) on female rats by determining serum reproductive hormone concentrations and observing their uterus tissue histology, determining the thickness of endometrium uterus, the uterine weight and the implantation rate. Administration of 0.05 of COCPs led to decrease the serum FSH concentration to 71.56 ng/ml while 750 mg/kg FSA extract led to decrease it to 25.62 ng/ml which shows that FSA extract is effective three times more than COCPs. The endometrium thickness of the uterus in the FSA extract treated group was normal while in the COCPs increased. The uterine weight in the FSA extract treated group was normal while the COCPs treated group was insignificantly high. The uterus tissues in the FSA extract treated group was normal while in the COCPs treated group, there were histopathological changes in the uterine tissues; the glands distribution decrease which a remarkable sign of atrophic endometrium and there were abnormal deciduiod cells (decidual like cells).