Leukocytosis Associated With Medroxyprogesterone in Gender-Affirming and Fertility Treatments

Leukocytosis, defined as an elevated white blood cell (WBC) count, can arise from physiological, infectious, neoplastic, or medication-related causes. While leukocytosis has been well-documented in conditions such as infections and malignancies, drug-induced leukocytosis is relatively rare, particularly in individuals undergoing gender transition therapies. Medroxyprogesterone, a progestin used in both fertility treatments and gender-affirming care, has been associated with hematologic changes, though its role in sustained leukocytosis remains underexplored. This case suggests a possible link between medroxyprogesterone and leukocytosis in gender-affirming therapy. It emphasizes the importance of thoroughly reviewing medication history to avoid unnecessary testing and procedures while highlighting the need for further research into the mechanism of progestin-induced hematologic changes.