If a young man's low testosterone is a problem for a couple trying to get pregnant , gonadotropin injections may be an option in some cases. These are hormones that signal the body to produce more testosterone. This may increase the sperm count. Hedges also describes implantable testosterone pellets, a relatively new form of treatment in which several pellets are placed under the skin of the buttocks, where they release testosterone over the course of about three to four months. Injections and nasal gels may be other options for some men.
Saw palmetto extract may decrease the effectiveness of estrogen products by reducing estrogen levels in the body via its antiestrogenic effects.  It can interfere with the use of birth control pills that contain estrogen as an active ingredient. As a result, it is recommended that an additional form of birth control, such as a condom, be used to prevent pregnancy in patients taking birth control pills with saw palmetto extract. In addition, saw palmetto extract can also interfere with hormone replacement therapy by reducing the effectiveness of estrogen pills. The combination of saw palmetto extract with estrogen products should be used with caution.