Context: It is still unclear whether postoperative gonadotropin-releasing hormone (GnRH) agonist treatment in patients with ovarian endometrioma who want to become pregnant is helpful for improving spontaneous pregnancy. Objective: This study evaluated spontaneous pregnancy in patients who had received three cycles of GnRH agonist treatment after conservative laparoscopic ovarian endometrioma surgery. Methods: Retrospective cohort study Patients: Forty-one patients who received three cycles of GnRH agonist treatment after laparoscopic surgery for ovarian endometriomas. Intervention: After finishing GnRH agonist treatment and undergoing hysterosalpingography, patients tried for spontaneous pregnancy for 12 months. Main Outcome Measure: Spontaneous pregnancy and recurrence of endometrioma within 12 months. Results: Forty-one patients with a mean age of 31.0 years (range: 25-38 years) were evaluated. Within 12 months, 51% percent (21/41) of patients conceived spontaneously. The mean duration to spontaneous pregnancy was 4.7 months. In addition, no endometrioma recurrence was found during the follow-up period. Conclusions: Three cycles of GnRH agonist treatment after conservative laparoscopic ovarian endometrioma surgery appear to be beneficial in patients who want to conceive spontaneously both in terms of pregnancy success and recurrence of endometrioma.