The high producing dairy cow of the 21st century is subfertile during lactation. Our objectives are to characterize physiological periods limiting reproductive performance and to describe integrated management strategies to improve pregnancy rates. Ovarian recrudescence with normal re-occurring estrous cycles and restoration of fertility to first service are associated with a reduced occurrence of periparturient metabolic and reproductive disorders. Marked negative changes in energy balance and reduced immunocompetence influence gonadotropic and metabolic hormones. Induced ovarian inactivity was associated with enhanced uterine involution. Post-partum health and reproductive performance were improved when by-pass lipids enriched in polyunsaturated fatty acids were fed in the pre- and post-partum periods. Pharmaceutical control of follicle, CL, and uterine function with PGF, GnRH and intravaginal progesterone releasing inserts, has permitted development of more optimal timed-insemination programs for first service. Likewise, resynchronization of nonpregnant cows coupled with the use of ultrasound for early pregnancy diagnosis provides the opportunity for a second timed-insemination within 3 days of a nonpregnant diagnosis. Bovine somatotropin (bST) increases embryo development and embryo survival when coupled with a timed-insemination program or cows detected in estrus. Presence of a conceptus alters endometrial expression of genes and proteins in response to bST and nutraceuticals (i.e., unsaturated fatty acids such as eicosapentaenoic and docosahexaenoic acid in by-pass lipids) to improve pregnancy rates. Postovulatory increases in progesterone may enhance pregnancy rates in targeted populations of lactating dairy cows, but timing and magnitude of the progesterone increases are pharmaceutically dependent.
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