My doctor switched me from clomid (clomiphene) to tamoxifen. is there the same increased chance for multiples with the tamoxifen?

Difficult to tell: Tamoxifen works very similarly to clomid (clomiphene). Because there is not a lot of published research on tamoxifen, it is difficult to compare the multiple birth rates. If you are 41 you indicated above, it is not a bad idea to see a specialist and consider more potent medications. Multiple births are not particularly common in 41 year olds, but pregnancy rates are lower.