Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Infertility, Female


Related Terms

  • Female Sterility
  • Postpartum Female Infertility
  • Postpartum Sterility

Differential Diagnosis

Specialists

  • Gynecologist
  • Reproductive Endocrinology Gynecologist
  • Urologist

Comorbid Conditions

Factors Influencing Duration

The treatment of underlying causes of fertility and the individual's response can influence the length of disability. If surgical treatment is necessary, it may lengthen disability, depending on complications.

Medical Codes

ICD-9-CM:
628.0 - Infertility, Female, Associated with Anovulation
628.2 - Infertility, Female, of Tubal Origin
628.3 - Infertility, Female, of Uterine Origin
628.4 - Infertility, Female, of Cervical of Vaginal Origin
628.8 - Infertility, Female, of Other Specified Origin
628.9 - Infertility, Female, Unspecified

Overview

Infertility is generally considered to be the failure to conceive a child after 1 year of unprotected sexual activity.

Major causes of infertility in women include anatomic abnormalities of the reproductive tract; disorders of the cervix such as infection, laceration, tearing from previous childbirth, or narrowing of the cervical opening for any reason; abnormal ovulation or irregular release of an egg (ovum) from the ovary, chemical changes in the cervical mucus, severe vaginitis, pelvic inflammatory disease (PID), ovarian cysts, endometriosis, and tumors. Hormone dysfunction secondary to diabetes, thyroid disorders, low levels of sex hormones, or elevated prolactin may also cause infertility. The lack of menstrual periods (amenorrhea), compulsive exercise, psychiatric disorders such as bulimia or anorexia nervosa, chronic emotional stress, and weight gain or weight loss cycles can also cause infertility.

Incidence and Prevalence: Exclusively female causes account for approximately 32% of infertility cases (Garcia).

Source: Medical Disability Advisor



Causation and Known Risk Factors

The effects of cigarette or marijuana smoking, environmental and occupational factors (e.g., excessive exposure to radiation), and the side effects of certain medications, including contraceptives, may increase a woman's risk of infertility.

Source: Medical Disability Advisor



Diagnosis

History: The individual will report failure to conceive. Women may have a history of past PID or sexually transmitted diseases. Some may report abnormal menstrual patterns, painful menstrual cycles, a history of endometriosis or other chronic illnesses.

Physical exam: The physical exam may be normal. Evidence of vaginal infections, fibroid tumors, or ovarian cysts may be found.

Tests: Tests include complete blood count (CBC), HIV testing, urinalysis, cervical cultures, blood tests for syphilis, rubella antibody, thyroid function, and sickle cell disease (in blacks), luteinizing hormone tests, serum progesterone level, follicle-stimulating-hormone level, prolactin level, histocompatibility antigen testing, ultrasound of the pelvis, hysterosalpingography, endometrial biopsy, laparoscopy, and genetic testing to rule out possible genetic causes of infertility. Cervical mucus will be tested. The semen of the male partner should be tested early on.

Source: Medical Disability Advisor



Treatment

Treatment depends on the underlying cause and may include hormone supplementation, antibiotics, fertility drugs, artificial insemination, surgery to correct blocked fallopian tubes, endometriosis, fibroids, genetic defects, or ovarian cysts. These problems are often evaluated and treated via laparoscopy.

Assisted reproductive technologies (ART) can also be used. In these cases, fertility drugs and other conventional treatment options are combined with high-tech procedures. ART procedures include in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT), intracytoplasmic sperm injection (ICSI), and donor egg or embryo IVF. The use of a surrogate mother is another ART method. The use of donor egg and/or sperm is also an option.
IVF is the most common type of ART and is often used when fallopian tubes are absent or blocked. In IVF, eggs are retrieved from the ovary and mixed with sperm outside the body. If fertilization occurs, the eggs are placed in the uterus.

Source: Medical Disability Advisor



Prognosis

A woman's chance of having a baby depends on many factors, including age and the underlying cause for infertility. If the underlying cause can be found and treated, the chances of conceiving are good. According to the Centers for Disease Control, in 2001 there were approximately 108,000 ART procedures started, which resulted in 41,000 live births ("Assisted").

Source: Medical Disability Advisor



Complications

The presence of infertility in both partners may complicate treatment. Multiple births and birth defects can create complications. Various ethical and moral decisions may need to be made throughout the diagnostic and treatment phase. Infertility that is severe or prolonged over 3 years is more difficult to treat. Advancing age may introduce a sense of urgency about treatment and further complicate treatment.

Psychological complications such as grief and depression may also occur. The inability to conceive a child can be emotionally disturbing to both partners.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Work restrictions depend on the treatment method. There may be activity restrictions if surgery is done, and frequent trips to the doctor may be necessary for follow-up care. Infertility tests and treatments are numerous and often time-sensitive. Therefore, the employer should be considerate and provide flexibility with scheduling. Heavy lifting or long periods of standing may need to be limited, depending on the surgical procedures performed.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Has individual consulted the appropriate medical fertility specialists?
  • Has individual had a thorough infertility workup?
  • Was the diagnosis of infertility confirmed?
  • Does individual struggle with grief, depression, anorexia nervosa, or bulimia?
  • Is the condition or its treatment complicated by factors such as advancing age, endometriosis, and ovarian or uterine tumors?

Regarding treatment:

  • Were underlying physical conditions effectively resolved?
  • Would individual and/or partner benefit from psychological counseling?
  • Were all appropriate options considered? Which ones have been tried so far?
  • What further options are individual and partner willing to try?
  • Were other pertinent factors addressed, such as exercise and weight gain, nutritional assessment, and psychotherapy or counseling if stress or other psychological factors are present?

Regarding prognosis:

  • Is individual prepared to spend the time and finances to attempt fertility?
  • Do individual and partner have a realistic grasp of the situation?
  • Have they seriously considered adoption as a viable option?

Source: Medical Disability Advisor



References

Cited

"Assisted Reproductive Technology Success Rates." Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. 12 Dec. 2004 <http://www.cdc.gov/reproductivehealth/ART01/nation.htm>.

Garcia, Jairo E., Lawrence M. Nelson, and Edward E. Wallach. "Infertility." eMedicine. Eds. Robert K. Zurawin, et al. 5 Oct. 2004. Medscape. 12 Dec. 2004 <http://emedicine.com/med/topic3535.htm>.

Source: Medical Disability Advisor






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