Fertility of the postpartum period is negatively influenced by the incidence of anestrus. The latter condition is characterized by the absence of estrous behavior, which may be an indication of suboptimal conditions (e.g., inadequate peripartum nutrition) or pathologic conditions (e.g., chronic debilitating diseases or uterine and ovarian diseases). Although initiation of ovarian follicular growth in the postpartum period is generally not affected, subsequent development (deviation) and the fate of the dominant follicle are the primary factors that affect reestablishment of ovarian cyclicity. Anestrus can be classified based on the three functional states of follicular development; that is, follicle emergence, deviation, and ovulation. Prevention of anestrus is preferable to treatment and can be achieved in part by maintaining a healthy periparturient period. To better understand the etiology of anestrus and its prevention, research is urgently needed in the following three areas: the role of peripartum disease conditions that influence reproduction, genes involved in ovulation, and the influence of proteins (e.g., leptin) that appear to be important links between metabolic signals and the neuroendocrine axis.
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