From pre-ovulatory follicle palpation to the challenge of twin pregnancies: Clinical reflections following one million gynaecological examinations in dairy cows.

CONTENTS: Based on experimental studies and extensive field-scale experience, this review offers new proposals for: (i) elevating the success of modern insemination procedures, (ii) emphasizing features of a pre-ovulatory follicle in the context of optimum insemination timing, (iii) overcoming heat stress and its consequences using physiological processes or endocrine protocols, (iv) establishing a viable pregnancy or early pregnancy loss and (v) the challenge of twin pregnancies. In conclusion, the fertility of high-yielding dairy cows can be further improved.