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This review describes factors that affect conception rate after synchronization of ovulation and timed artificial insemination. Intervals of 7 days between GnRH and PGF2alpha, 48 hours to the second GnRH treatment and a further 16 to 20 hours to the timed insemination have been proven to be most effective. Conception rates (CR) increase as lactation progresses up to 100 days in milk. Primiparous cows have higher CR than older cows. Anovular cows at the start of the synchronization protocols have poor CR. These are highest for cows started in early dioestrus. While poor body condition and some post partum and post insemination health disorders have negative effects on the CR, a significant effect of postpartum chronic endometritis could not be demonstrated. High milk yield was also not shown to have a negative effect on CR in almost all studies, while the negative effect of heat stress on fertility is also found in Ovsynch cows. However, the negative effects of high milk yields and heat stress on AI submission rates are overcome by the timed insemination protocol.