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Endometriosis is the presence of endometrial like tissue at sites other than the uterus, with an increased activity of estrogen receptors & resistance to progesterone in those sites thus, inducing an intense inflammatory response. Ovarian endometrioma is one such manifestation which affects 17-44% of females with endometriosis. Numerous studies reveal that ovarian endometrioma is associated with poorer fertility outcome, especially with bilaterality of the disease. Surgical management with or without ART has been the main stay of management strategy when a women is desirous of conception & successful pregnancy outcome in patients with ovarian endometrioma. However, the main concern remains the decreasing ovarian reserves as suggested by various studies when patient underwent cystectomy, though a few studies support that decreasing ovarian reserve post-surgery could be multifactorial. In this case report of a 21 year old P0L0A1 patient with large bilateral ovarian endometrioma who was put on GnRH agonist therapy for a period of 3 months instead of undergoing surgery, we found that there was not only a regression in the size of endometrioma but patient also conceived and had a successful pregnancy outcome.