There is much debate about possible antagonism between high milk production and reproductive performance. This paper reviews methods of measuring reproductive performance and the association of the level of milk production with pregnancy rate at the herd and individual levels. The main question is whether fertility (the capacity for reproductive function and successful pregnancy) of dairy cows has in fact declined, as opposed to the success of management systems and people at meeting the metabolic, nutritional, housing, and social needs of increasingly productive animals but with no less inherent capacity to achieve and maintain pregnancy; and if fertility really has diminished, the extent to which this decline is caused by increased milk production. There is no doubt that production per cow has increased, but it is unclear how much of this increase can explain the apparent decrease in fertility. It is important to separate the biology of reproductive function from the effects of economically based management decisions about culling and continuation of breeding. Most traditionally-used measures of reproductive performance (calving interval, conception rate, non-return rate) are incomplete or severely biased outcome measures. Both herd and cow-level data should include as much information as possible on confounders of the relationship of production with reproduction. Population or herd-level data should not be used to make inferences about individual-level associations. Considering the quality of data and analytic methods in the published literature, it is not clear if there is any association between higher milk yield and the probability and timing of pregnancy, either among cows at various levels of production in a population at one time, or with increasing production over time.