Objective — to assess the impact of empirical therapy for endometrial sizes dynamics of treatment and pregnancy rate. Material and methods. A total of 38 patients of main group (28,8±0,77 years) with single (34) and bilateral (4) of endometriomas to 3—4 cm, 13 of whom suffered from infertility (1-st main group). The research of tumor marker CA 125, a basal level of FSH, estradiol, AMH, inhibin B, activin A in the serum by ELISA and echographic study of the pelvic organs. Results. The level of CA 125 in the endometriomas totaled 29,0 (16,5; 33,0) U/ml, in the 1-st main group — 30,5 (28,63; 32,75) U/ml, with recurrent endometrioma — 39,35 (37,75; 51,70) U/ml. Hyperestradiolemiya established patients of the main group with respect to the control group (p<0,05). In the 1-st main group — reducing AMH, inhibin B, and activin A relative increase in the comparison group (p<0,05). In order to preserve ovarian reserve conducted conservative treatment dienogest 2 mg for 6 months from the ultrasound control after 3 and 6 months of treatment and evaluation of the frequency of pregnancy after the empirical treatment. Conclusions. Upon completion of the empirical treatment with dienogest for 6 months in patients with endometriomas found downsizing endometrioma 1,8 times (p<0,05), the restoration of natural fertility in 30,8% of cases.