Infertility is defined as a failure to conceive within one or more years of regular unprotected coitus. In Ayurveda infertility may be correlated with Vandhyatva. Ovarian endometrioma is common disease among women, from ayurvedic perspective, endometrioma can be categorised under Vatiki Yonivyapad based on the nidana and lakshanas. Virechana Karma mainly indicated in the treatment of all the Yonirogas & also plays an important role in the management of various Stree Rogas. The present case report revealed Shodhan effect of Virechana Karma along with Artavajanana properties of kalyanaka ghrita and for snehapana. In a known case of primary infertility. Virechana Karma along with these drugs found to be improved remarkably the functions of female reproductive system. After this treatment successful conception is achieved in that patient. METHODOLGY: A female patient aged 28 years with a marital life 6 years, NCM, she had history of laparoscopy in the year of 2022 for right ovarian endometrioma. On examination, the body proportion was found to be normal with normal secondary sexual characters. There was no any abnormal finding seen in the physical and pelvic examination (per speculum & per vagina). The selected treatment protocol includes Shirodhara, Deepana, Pachana, Snehana and Virechana are found to be effective in the management of Vandhyatva. RESULT: After a consecutive menstrual cycle, patient conceived after treatment (UPT done at home came positive). Patient has successfully delivered a healthy male baby with no complications. DISCUSSION: It has been said that conception will takes place in a suddha yoni, which is achieved after Shodhana Chikitsa. For Shodhana, Virechana was done. Since, Virechana is the best treatment for Beeja Karmukatha. Other treatment like Shirodhara helped in correcting Manasika factor which is chief factor responsible for conception and maintenance of pregnancy. Thereby ayurvedic management can act as an anti-stress and antioxidant agent improving the reproductive health of women and increasing their chances of conception and paves way for healthy progeny.