Conservative management of patients with endometrial cancer who desire fertility is becoming widespread in certain circumstances. A 36-year-old women desiring fertility with early-stage endometroid type adenocarcinoma of the endometrium was treated with 160 mg/d megestrol acetate for six months. After confirmation of a normal endometrial biopsy she became pregnant spontaneously. Following an uneventful pregnancy a healthy baby at term was delivered by cesarean section. Definitive surgery was performed. The risks and benefits of this thereupeutic approach are discussed and informing style of the patients emphasized.