An author is undergoing multiple fertility therapies to get pregnant, putting her relationship with her husband on edge.
Richard (Paul Giamatti) and Rachel (Kathryn Hahn) are a middle-aged couple desperately trying to have a child. After multiple failed attempts at artificial insemination, they attempt in vitro fertilisation. The couple learn that Richard has a blockage that is not letting him produce sperm, forcing him to undergo a surgery that puts him $10,000 in debt to his brother Charlie and his wife Cynthia. At the same time they are also attempting to adopt a child after connecting with a supposedly pregnant teenager from Arkansas looking to give up her child but then stopped contact.