For several decades, researchers worldwide report a decrease in fertility in high-yielding dairy cows, most probably based on conflicting metabolic and reproductive needs. The dairy herd manager's success at improving milk production has been accompanied by a negative trend for the most visible reproductive parameters such as calving intervals, number of days open and number of inseminations needed per pregnancy. In parallel, many research groups studied the metabolic and endocrine factors that influence follicular growth and the developmental competence of oocytes and embryos. In the past, herd managers and reproductive biologists each tried to tackle the same problems with limited consultation. More recently, the situation has improved significantly and theriogenologists, nutritionists and veterinarians now conduct research in multidisciplinary teams. This review paper starts in a general way by discussing nutrient prioritization towards the udder to guarantee milk production and by describing interactions between the somatotropic and gonadotropic axis. It then focuses on the consequences of the negative energy balance on follicular growth and environment, oocyte and embryo quality, not only by summarizing the currently accepted hypotheses but also based on clear scientific evidence at the follicular level. All this, with one question in mind: is there a mismatch between metabolism and fertility and what can the dairy manager learn from research to tackle the problem of reduced fertility?
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