This observational study was conducted to evaluate the effect of transition cow health on pregnancy per artificial insemination (P/AI) and pregnancy loss (PL) in cows submitted to a Double-Ovsynch protocol (DO) for first service. Lactating Holstein cows (n = 15,041) from one commercial dairy farm in northern Germany between January 2015 to December 2021 were enrolled into a modified Double-Ovsynch protocol (GnRH, 7 d later PGF2α, 3 d later GnRH, 7 d later GnRH, 7 d later PGF2α, 24 h later PGF2α, 32 h later GnRH, and 16 to 18 h later timed artificial insemination) for first service at 72 ± 3 d in milk. Pregnancy was diagnosed at 32 and 60 d post-AI via transrectal ultrasonography. Pregnancy loss was defined as the proportion of cows diagnosed pregnant 32 d post-artificial insemination that were diagnosed nonpregnant 60 d post-artificial insemination. Health-related events (i.e., milk fever [MF], hyperketonemia [KET], retained fetal membranes [RFM], metritis, mastitis, left displaced abomasum [LDA]) were assessed by farm personnel using standard operating procedures. Multivariable logistic regression was used for testing potential associations between transition cow health event occurrence and outcome variables, including P/AI and PL. Three separate models were built for cows in first lactation, second lactation, and ≥third lactation. Overall, 20.0% (885/4,430), 34.9% (1,391/3,989), and 53.9% (3,570/6,622) of cows had at least one transition cow health event for first, second, and ≥third lactations, respectively. The most prevalent transition cow health event for first-lactation cows was metritis (10.7%; [473/4,430]), whereas second-lactation cows suffered mostly from mastitis (16.6%; [664/3,989] and KET (16.6%; [661/3,989]), and cows with ≥third lactations were mostly affected by KET (33.2%; [2,198/6,622]). We observed a negative association between inflammatory disorders (i.e., RFM, metritis, mastitis) and P/AI in all cows irrespective of parity. Metabolic disorders (i.e., MF, KET, LDA) were negatively associated with P/AI only in multiparous cows. Irrespective of parity, only uterine diseases (i.e., RFM, metritis) were significantly associated with PL. These results show that enrolling cows into a fertility protocol, such as DO, cannot overcome the carryover effects of inflammatory and metabolic disorders on P/AI and PL and highlight the importance of optimizing transition cow health as a prerequisite for achieving high fertility in a DO protocol.
