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CPT symmetry equates the diagonal entries of the decay-effective Hamiltonian operator. It does not make this effective matrix Hermitian operator; its imaginary diagonal part describes a total decay width.

Starting from a matter-antimatter symmetric ensemble, exact charge conjugation would pair every baryon-producing process with an equally probable antibaryon-producing process. Their contributions to the net baryon number cancel. Thus C violation is necessary. Violating charge conjugation alone is insufficient: if CP symmetry is exact, the parity-reflected conjugate channels still have equal probabilities and cancel in a CP symmetry invariant ensemble. One needs CP violation as well.

The remaining Sakharov conditions are baryon number violation and departure from thermal equilibrium. Conserving baryon number cannot turn an initially zero value into a nonzero one. In thermal equilibrium, under the usual CPT theorem hypotheses and with no imposed chemical potentials for charges odd under CPT symmetry, states and their conjugates have equal thermal weights, so the equilibrium expectation of net baryon number vanishes and thermal stationarity prevents its sustained production. A nonequilibrium history allows different forward and reverse populations to generate an asymmetry. These are the standard necessary conditions for dynamical baryogenesis from symmetric initial conditions, not a guarantee of a sufficiently large asymmetry.

Let $|1⟩=|D^0⟩$, $|2⟩=|{\bar{D}}^0⟩$. In the rest frame, the CPT theorem interchanges these states up to irrelevant phases. For the weak Hamiltonian operator $H^{\prime }$, with $H^{\prime }=H^{\prime †}$, and its antiunitary CPT symmetry operator $\Theta$,Its diagonal matrix elements are real by Hermitian conjugation, soIn the specified phase convention, the CP symmetry operator on this two-state subspace is $-{\sigma }_x$. If the weak interaction preserves CP symmetry, ${\sigma }_{x}R{\sigma }_x=R$, givingIndependently, Hermitian conjugation gives $R_{21}=R_{12}^{\ast }$ for this $H^{\prime }$. Hence CP symmetry makes the off-diagonal element real in this convention; that conjugation relation alone does not imply CP symmetry.

For neutral meson mixing described by the decay-effective Hamiltonian operator $R=M-i\Gamma /2$, the effective matrix is generally not a Hermitian matrix. The CPT constraints on neutral-meson mixing still give equality of the complex diagonal entries, expressing equal masses and total decay widths, and CP symmetry gives equality of the off-diagonal entries in the specified convention. One must not additionally impose $R_{21}=R_{12}^{\ast }$ on this decay-effective matrix.

The standard conditions for baryogenesis from a symmetric initial ensemble are baryon number violation, both C violation and CP violation, and departure from thermal equilibrium. Conserved baryon number cannot develop a net value from zero; an exact conjugation symmetry pairs production with equal antiproduction. In thermal equilibrium, CPT symmetry makes the equilibrium expectation of net baryon number vanish for zero imposed chemical potentials for charges odd under CPT symmetry. These conditions assume the usual local quantum-field framework and do not alone guarantee a large asymmetry.