Throughout the 70s, 80s and 90s, the global popularity of the Holstein cow continued to climb in line with her improved performance. Heavy selection emphasis on production resulted in impressive gains, but at the expense of health and fertility, traits that are negatively correlated with production. With the new century, health and fertility were included in selection indexes and slowly the tide has turned: Health and fertility of the Holstein is improving again. Here we examine the evaluation methods used worldwide for fertility.