The reproductive parameters of dairy cattle have continuously declined worldwide over the last 50 years. Nutritional imbalances are identified as risk factors for this decrease of reproductive performance. The present paper aims to quantify the decrease in the pregnancy per artificial insemination (P/AI) in the case of high milk ketones before and after AI. A total of 388,731 test-day from the Brittany Milk Recording Program in France from 226,429 cow-lactations were provided for this trial. For each test-day, information about lactation characteristics, date of AI, date of the following calving, and acetone and beta-hydroxybutyrate (BHB) values were included. Ketones were predicted by Fourier transform mid-infrared spectroscopy using MilkoScan Foss analyzers (Foss, Hillerod, Denmark). Many thresholds were evaluated to define cows with hyperketolactia. Hyperketolactia statuses were then categorized into 1 of 4 possible classes according to the milk ketone dynamics for each AI and each threshold of acetone or BHB values (low-low, high-low, low-high, and high-high) within 20 d before and after AI. Similarly, the dynamics of udder health were characterized by changes in somatic cell counts measured at the same test day as ketone bodies. A logistic regression with a Poisson correction was performed to explain the relationship of P/AI with milk ketones and somatic cell count dynamics. Predicted acetone and BHB ranged from - 0.51 to 4.92 mM (mean = 0.08 mM, SD = 0.10 mM) and - 0.62 to 5.85 mM (mean = 0.07 mM, SD = 0.1 mM), respectively. Hyperketolactia defined by high acetone levels before AI was not associated with decreased P/AI, but high acetone levels after AI were associated with a >10% reduction in P/AI for all thresholds >0.10 mM.