Antonis Makrigiannakis

Professor of Obstetrics and Gynecology
University of Crete

Antonis Makrigiannakis was born in Rhodes. He graduated from high school in Heraklion and passed the national examination to be admitted to the University of Athens Medical School (1981). He graduated from Medical School in 1988 and I served my military service as a medical officer in the Hellenic Air Force (1988-90). He then served the mandatory rural medical service (1990-91). He started working towards my doctoral degree in 1989, at the Laboratory of Endocrine Pharmacology, Basic Sciences Division, Faculty of Medicine, University of Crete, Greece. He completed his PhD thesis in 1994, and left for the USA for further training. Then, he followed training as a General Surgeon (1992-93), which is a prerequisite for the specialty of Obstetrics & Gynecology. Thenafter (1993-97), he followed training towards the specialty of Obstetrics & Gynecology, at the Ob-Gyn Department of the Faculty of Medicine, University of Crete.

Antonis Makrigiannakis was trained in Assisted Reproduction (including in vitro fertilization, IVF) and Gynecological Endocrinology in two of the largest centers worldwide: 

1) Division of Human Reproduction, Department of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, USA. 

2) Imperial College School of Medicine, Hammersmith Hospital, Department of Reproductive Surgery & Medicine, In Vitro Fertilization Unit, London, UK. 

In 2001, he was elected Assistant Professor of Obstetrics and Gynecology, he obtained a tenured position in 2006, and he was elected Professor of Obstetrics and Gynecology, Medical School, University of Crete in 2010.  He also founded the IVF, Assisted Reproduction and Gynaecological Endocrinology Unit, as well as the Recurrent Miscarriages clinic within the Obstetrics and Gynecology Department of the University of Crete. 

Research projects & interests

His research focuses on the mechanism of embryo implantation, as well as on tackling endometrial receptivity disorders in cases of recurrent assisted reproduction/IVF failure. His first significant contribution to the understanding of the implantation mechanism was the elucidation of the embryo immune tolerance mechanism on the mother’s side during blastocyst implantation. In a study carried out in the USA, it was shown that both the blastocyst (early embryo) and the decidua secrete corticotropin-releasing hormone (CRH), which induces apoptosis (programmed cell death) of lymphocytes homing locally to the implantation site. Thus, the graft-host reaction is inhibited; such a reaction should be expected, as the embryo is regarded as a semi-allograft (the father’s contribution rendering it non-self in half, vs. the mother) (Makrigiannakis et al, Nat Immunol 2001). By extending the study to the early implantation phases, it was proved that the same hormone (CRH) regulates the depth of implantation (Bamberger et al, 2006) and that abnormal implantation due to deficient CRH regulation is essentially associated with abnormal placentation disorders, such as preeclampsia and intrauterine growth retardation (Petsas et al, 2014). Furthermore, in a parallel study, it was shown that increased CRH concentration is related to first trimester miscarriages by inducing trophoblast apoptosis (Minas et al, 2007). 

He is particularly interested in patients characterized by repeated implantation failures. Although there is no clear definition characterizing these patients, it is widely accepted that a repeated implantation failure case is a patient having failed to establish a clinical pregnancy after three IVF attempts with good quality embryos. These patients usually and understandably experience anxiety and stress, which ultimately makes them “non-responsive” to further attempts. A successful IVF outcome in cases of repeated implantation failure is a challenge for me, both on the clinical and research levels. In study in new ways of improving the efficiency of assisted reproduction methods, he organized and published a pilot study, in which a significant increase of IVF efficiency was achieved by preparing the endometrium with CRH, and by the intrauterine administration of autologous mononuclear cells (Makrigiannakis et al, Eur J Clin Invest, 2015). He has also been interested in the molecular mechanisms of folliculogenesis and follicular dysfunction and published 136 papers to date. Most of these publications reflect his research activity in Greece, as well as his research abroad. He also co-authored 3 chapters in scientific textbooks published internationally, and 2 chapters in Greek scientific textbooks and has published 14 papers in Greek scientific journals.