BackgroundDrivers of change in dairy herd health management include the significant increase in herd/farm size, quota removal (within Europe) and the increase in technologies to aid in dairy cow reproductive management.Main bodyThere are a number of key areas for improving fertility management these include: i) handling of substantial volumes of data, ii) genetic selection (including improved phenotypes for use in breeding programmes), iii) nutritional management (including transition cow management), iv) control of infectious disease, v) reproductive management (and automated systems to improve reproductive management), vi) ovulation / oestrous synchronisation, vii) rapid diagnostics of reproductive status, and viii) management of male fertility. This review covers the current status and future outlook of many of these key factors that contribute to dairy cow herd health and reproductive performance.ConclusionsIn addition to improvements in genetic trends for fertility, numerous other future developments are likely in the near future. These include: i) development of new and novel fertility phenotypes that may be measurable in milk; ii) specific fertility genomic markers; iii) earlier and rapid pregnancy detection; iv) increased use of activity monitors; v) improved breeding protocols; vi) automated inline sensors for relevant phenotypes that become more affordable for farmers; and vii) capturing and mining multiple sources of “Big Data” available to dairy farmers. These should facilitate improved performance, health and fertility of dairy cows in the future.