For doctors, midwives and regulators
The full specification — recording parameters, the algorithm verbatim, the evidence base,
scope and test procedure. Every threshold matches the shipped state; none of them is
simplified here.
Recording parameters and resolution
Basal body temperature 35.0–40.0 °C in 0.05 steps · bleeding in four intensities plus
“none” · cervical mucus in 4 levels by quality · cervix in 3 levels (optional, off by
default) · resting heart rate 40–160 bpm (optional, off by default) ·
15 symptoms, two of them (hot flush, night sweats) with an optional daily
level of mild/moderate/severe · free text.
Missing fields are carried as missing, not as a zero value. Intercourse can be recorded but
enters no calculation.
The algorithm verbatim
Cycle segmentation — day 1 = bleeding ≥ light, minimum gap
15 days, bleeding duration.
Ovulation confirmation — coverline from six low readings, 3 above it
with ≥ 0.2 °C, fallback criterion of a fourth reading, ovulation day, mucus peak,
window edges.
Statistics — median cycle length over the entire history,
range and variation windowed to the last 6 completed cycles, luteal phase
as the median over the evidenced ovulations — with no minimum count, from the first
one on.
Forecast — period date, ovulation point, order of precedence, window
formulae.
Confidence levels — five: average · wide · medium ·
narrow · no window from a windowed variation of ≥ 14 days — the one
state in which no point is forecast; a window already measured is untouched by this.
Symptom-phase tally — window: the last 6 completed cycles, identical to
the variation window; ≥ 3 evidence days, 50–75 % tendency, from 75 % a pattern,
max. 3; the day level decides whether a pattern holds, what is shown
is the cycle coverage as a fraction with a capped denominator; three states
per cycle — hit, recorded and not present, not recorded; with no completed cycle there is no
denominator and therefore no confirmation.
Dissenting voices in the guidelines — and the answer to them
Three guideline bodies judge basal body temperature as an instrument for confirming
ovulation with reservation or rejection. They stand here verbatim: a specification that
leaves out the counter-finding is not a specification.
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NICE NG257, Fertility problems: assessment and treatment (NICE
guideline, published 31 March 2026), recommendation 1.18.9:
“Do not use basal body temperature charts to confirm ovulation because they do not
reliably predict ovulation.” — marked [2004], carried over unchanged in the 2026 update.
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Practice Committee of the ASRM, Fertility evaluation of infertile
women: a committee opinion, Fertil Steril 116(5), 1255–1265 (2021):
“Serial, daily basal body temperature (BBT) testing is an inexpensive, although often
unreliable, method of predicting ovarian function.” … “Given the tedious nature of the
testing and its lack of accuracy, this test is not routinely recommended today,
especially when the menstrual history is consistent with ovulatory cycles.”
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ESHRE, Evidence-based guideline: Unexplained Infertility
(2023): for basal body temperature against ultrasound follicle monitoring as the
reference standard, sensitivity 77 %, specificity 33 %, accuracy
74 % (Guermandi et al. 2001, 101 women with regular cycles).
Recommendation: tests to confirm ovulation are not routinely indicated where the cycle is
regular; where confirmation is indicated, the guideline names the LH urine test,
ultrasound and mid-luteal progesterone — not basal body temperature.
The answer, in five points:
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The subject is a different one. All three judge basal body temperature as
a diagnostic instrument in infertility work-up — as a substitute for ultrasound,
an LH test or a progesterone measurement. Takt replaces none of these procedures and
enters no work-up: it documents an analysis that the woman using it could carry out
herself by the same published rule.
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The physiology is not disputed. None of the three bodies contradicts the
biphasic course; ASRM 2021 records it expressly (“Ovulatory cycles are generally
associated with biphasic BBT recordings”). What is disputed is the reliability as
proof, not the pattern.
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The reservation applies to confirmation — and that is exactly where Takt’s ladder
of levels sits. A temperature rise alone yields the level
probable in Takt, not confirmed; “confirmed” is reserved for the
double check of temperature and cervical mucus peak. The level words are created at
exactly one place in the source (
lib/model/evidenz.dart), not afresh on every
surface. Two automated guards back this up: a vocabulary test keeps blocked terms out
across the entire body of text, and a state-aware check additionally requires an evidenced
ovulation for the word “confirmed” — wherever Takt assembles its sentences at runtime.
The reservation therefore lands on a statement Takt does not make from one sign.
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The sensitivity gap is the reason for a fixed rule. A share of ovulatory
cycles shows no clearly biphasic curve — ASRM 2021: “Some ovulatory women cannot document
clearly biphasic BBT patterns”; quantified in Moghissi 1976 (Fertil Steril 27(12),
1415–1421) as “approximately 20 % of ovulatory cycles” in 30 women, one cycle
each. The consequence in the product: a rule that is not met is not a
finding. Takt says “not evidenced yet” and never “no ovulation”
— a statement about an ovulation that failed to occur would be a pathological finding and
is ruled out.
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Takt derives no accuracy claim about itself from any of this. What is
given is the computed window width, never a hit rate — and the evidence level a statement
stands on.
What does not follow from this: this answer justifies Takt’s choice of
words and its evidence levels — not a suitability for contraception and not one for
investigating cycle disorders. Takt is intended for neither (see
“What Takt is not”). The figures named describe the method in a
clinical population, not the product.
Evidence base — implemented and deliberately not implemented
The four load-bearing sources, each with its function, are set out in full under
“What the rules rest on”.
Reviewed but not implemented: Shi et al. 2026, Wang et al. 2025 and
Thigpen et al. 2025 on wearable sensors. Takt does not implement these methods and
therefore relies on none of their figures. Two limitations of this literature come on top:
error margins determined retrospectively, and manufacturer funding with LH rather than
ultrasound as the reference.
Why Takt names no accuracy figure of its own: there is no prospective
validation. What is given is the computed window width, not a hit rate.
Scope and limits of the specification
Confirmation is retrospective · a confirmed ovulation does not anchor the current period
date · there is no automatic outlier handling · irregular cycles (Yu et al. 2022:
sensitivity 69 % for regular, 21 % for irregular cycles) · no substitute for
medical assessment.
Scope of the analysis rule. The symptothermal rule and the statistics
derived from it have been studied for cycles in the reproductive normal range
without hormonal contraception. For adolescence, perimenopause, postpartum
cycles, PCOS, thyroid dysfunction and for cycles under hormonal contraception there is
no study of the rule — for perimenopause that is a gap in the evidence, not
in the literature search: a quantified study of the symptothermal method in this phase does
not exist, and the developers of the method themselves list it as a “special situation”
calling for instructor support rather than automatic application of the rule. Takt applies
the rule there unchanged and knows no special-case detection. Recording, history and
the doctor’s report are untouched by this — they do not presuppose the rule.
What Takt does do in these phases is document and display: record signs and
symptoms, show their course, prepare the material for the consultation. Takt does
not place anything in a stage, rate a severity or forecast the transition —
not because the data is missing, but because that is not the purpose.
Reproducibility and test procedure
A pure function with no randomness, no network, no server-side rule update · personas across
the whole span of life · vocabulary test · catalogue of statements · 75 reference vectors
against external guidelines (AWMF/Sensiplan, FIGO) · 20 frozen schema versions · a lock
against changing the computation logic without a matching update of tests and explanatory
text.
This is not a certified QMS under ISO 13485 — for a product outside
the MDR, none is envisaged.
The doctor’s report in detail
Header line · FIGO reference ranges with the 2019 corrigendum (cycle length
24–38 d, < 24 frequent / > 38 infrequent · variation
≤ 7 d at 26–41 years, ≤ 9 d at 18–25 and 42–45 years ·
bleeding duration ≤ 8 d · bleeding intensity qualitative, no mL
threshold) · range instead of mean · the logic of the summarising sentence ·
measurement coverage, time reference (“biphasic · in 4 of 5 cycles”) and the raw record as
evidence for every figure.
Age banding. Takt asks for the year of birth and selects the FIGO threshold
accordingly (≤ 7 days at 26–41 years, ≤ 9 at 18–25 and 42–45). Without a year of
birth the axis is shown but not assessed, rather than testing against the laxer limit.
Why a year and not a date is enough is explained by the app
in the sheet “Why Takt asks for your year of birth”.
The 2019 corrigendum corrects the swapped categories “frequent”/“infrequent” and the
irregularity threshold.