Richard and Rachel 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 who was looking to give up her child but then stopped contact.
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After the IVF fails, their doctor floats the idea of using a donor egg to implant in Rachel, raising their chances of success from 4 to 65 percent. Rachel is initially against it, but slowly begins to consider it with Richard’s encouragement.
Meanwhile, their 25-year-old niece, Sadie, decides to leave her college writing program to finish in absentia and go live in New York City with Richard and Rachel, with whom she is already very close. Rachel, who struggled with the idea of an unknown egg donor, decides to ask Sadie for her eggs. To their surprise, Sadie quickly agrees, both because she loves Richard and Rachel and because she thinks the egg donation will bring meaning to her life.
At Thanksgiving dinner, Sadie informs her family that she will be donating her egg to Richard and Rachel, much to her mother’s chagrin. Despite the fact that Richard and Rachel tell Cynthia they will not go through with the donation without her consent, they decide to go through with pre-screening.
Richard, Rachel and Sadie happily go through the egg donor treatments together, but Sadie is told at an appointment that she is not developing eggs quickly enough. Determined not to let Richard and Rachel down, she increases her drug dosage on her own. The egg retrieval is a success, but Sadie becomes ill. Richard and Rachel take her to the hospital, where they learn of the increased dosage. Sadie moves out of their apartment.
Richard and Rachel go through with the implantation, but it is a failure. While Rachel is devastated, Richard admits to being relieved that they are finally done with trying as their marriage and intimacy have suffered.
Sometime later, they drop Sadie off at the Yaddo colony, where she will take up a residency as a writer. She thanks Rachel for her help getting in, but Rachel informs her she did nothing to aid her application and that Sadie did it all on her own.
Nine months later, Richard and Rachel receive a call from another woman looking at them as potential parents to adopt her child. They drive to a restaurant, where they wait to meet the woman. Richard moves from his usual opposite seat and sits next to Rachel to hold her hand.