Pregnancy losses are substantial in dairy cattle and threaten reproductive efficiency. Approximately 60% of the fertilized oocytes are lost during development and fail to generate a live calf. Whereas early embryonic losses are more frequent, fetal mortality occurring later in development are more costly. The elongation phase of preimplantation conceptuses is critical in this context because 1) 39% of blastocysts fail to elongate and 2) events occurring during this period are important for subsequent maintenance of pregnancy. The onset of elongation is marked by dynamic changes in the transcriptome of trophectoderm cells. Peroxisome proliferator-activated receptor gamma (PPARG), a nuclear receptor activated by binding of fatty acids, coordinates a substantial portion of these changes. In addition to having its own transcript expression increased during elongation, PPARG also promotes transcript expression of genes related to uptake, oxidation, modification, and de novo biosynthesis of fatty acids and prostaglandins. Lipid droplets of epithelial cells in the endometrium seem to be the major source of lipids for conceptus utilization. Therefore, endometrial lipid profile is likely to regulate PPARG activity in conceptuses and the success of elongation. Formation of lipid droplets is induced by progesterone and its composition can be altered by diet and health status of the cow. About 40% of dairy cows develop inflammatory diseases postpartum, which impairs conceptus elongation and increases the likelihood of pregnancy loss. Uterine environment is a major contributor for this cause of subfertility because these outcomes are also observed following embryo transfer. Inflammation alters lipid composition of tissues because such molecules are used as inflammatory mediators. Thus, changes in composition of endometrial lipids might be involved in subfertility of cows developing postpartum inflammatory diseases. Targeting of uterine lipid metabolism and PPARG activity during preimplantation conceptus development through health postpartum and nutraceutical diets are good strategies to improve survival of pregnancy in dairy cows.