Coming at a time of increasing concern about the declining fertility of high-yielding cows the organisers of this conference are to be congratulated on achieving a well-balanced programme representative of the breadth and depth of the science that is now being directed to the problem of dairy cow infertility. From a starting point of uncertainty about how to deal with the problem, delegates came away very well informed scientifically and, if perhaps with varying views as to the best way forward, more aware of the multidisciplinary research and development approach now being used to investigate it. The purpose of this perspective is to capture, along with the broad issues, the relevant technical detail of the papers and discussions in a way that hopefully provides a balanced overview of the conference.