Achieving adequate fertility is essential in any dairy unit, but is compromised by genetic selection for increased yield. Selection has altered the somatotrophic axis and resulted in cows which mobilise more body tissue for milk production in early lactation, thus prolonging both the depth and duration of the post partum negative energy balance. Poor energy status is reflected in altered metabolic parameters including raised urea and decreased insulin-like growth factor-I (IGF-I) and insulin concentrations, which adversely affect ovarian cyclicity and early embryo survival. Attempts to optimise the diet in terms of energy and protein content have generally been aimed at increasing milk production further rather than improving fertility. Advances in biosensor technology now provide us with the opportunity to monitor production, fertility and health parameters of each cow. Integration of this information should improve the timing for inseminations and could assist in selecting diets more suited to the needs of the individual cow. Genetic selection may in future be used to produce cows optimised for a particular type of management system. In both cases we need a greater understanding of the rules governing nutrient partitioning at different stages of the cows' life cycle to ensure that diets selected are cost effective and achieve an appropriate balance in promoting production, reproduction and health.