Acquired idiopathic chylous ascites is extremely rare in women of reproductive age. This is the first report describing successful infertility and pregnancy management in a patient with idiopathic chylous ascites. A 23-year-old woman presented with abdominal distention and was diagnosed with idiopathic fluid collection. A lymphogram revealed lymphatic leakage from the right renal hilum. Lymphatic-venous anastomosis of the thoracic duct was performed thrice, but the chylous ascites persisted. In vitro fertilization was performed because natural conception was not possible. Just prior to oocyte retrieval, transvaginal drainage of ascites was performed. In total, nine blastocysts were obtained and cryopreserved. Single frozen embryo transfer was performed, including hormone replacement therapy. The patient became pregnant and the ascites spontaneously decreased as the pregnancy progressed, finally disappearing around gestational week 20. A healthy baby was delivered transvaginally. Ascites began to reaccumulate on post-partum day 1 and returned to the pre-pregnancy level within a month.