Colleen Hoover’s 2018 novel All Your Perfects depicts a marriage in crisis as a result of infertility and infidelity. Hoover is known for her contemporary romance and young adult novels, as well as psychological thrillers. All Your Perfects appeared on both the New York Times Bestseller list and USA Today’s Best Selling Books list. The novel alternates between scenes set “Then” (when couple Quinn and Graham are just beginning their relationship) and “Now” (seven years later, when their marriage has been tested by infertility). The novel is a romance novel, but subverts many genre expectations by focusing on an established relationship in crisis.

Content Warning: All Your Perfects includes emotionally fraught discussion of infertility (i.e., how cultural biases about fertility affect a person’s self-esteem), an instance of self-harm, and a miscarriage.

Plot Summary

All Your Perfects opens seven years in the past, when Quinn discovers her fiancé, Ethan, sleeping with another woman. She receives this news from the woman’s boyfriend, Graham, with whom she quickly hits it off. Quinn and Graham almost engage in rebound sex, but are too emotionally affected by their partners’ cheating. Graham leaves Quinn his phone number, but she never calls it. Six months later, they run into each other by chance and reconnect, quickly starting an intense romantic relationship.

The novel alternates between scenes set “Then” (seven years ago, at the beginning of Quinn and Graham’s relationship) and “Now” (the present). In the present, Quinn and Graham have been experiencing infertility for years and have been profoundly changed by feelings of guilt and shame. Quinn cannot conceive because of her endometriosis, and the couple cannot adopt because of a criminal conviction in Graham’s youth. They try three unsuccessful rounds of IVF and are rejected by several adoption agencies. Quinn feels deep shame about her inability to conceive a child; this is accompanied by guilt over denying Graham the opportunity to be a father. She copes with these feelings by withdrawing from Graham—crying in the shower and avoiding physical intimacy when it’s not for conception—but also begins to view sex as traumatic.

“Then” flashbacks to the rapid progression of Quinn and Graham’s relationship. Graham views their relationship as fated, which unnerves the more cautious Quinn. However, Quinn’s hesitance is overcome by her deep love and appreciation for Graham. She meets and loves Graham’s close-knit family, as her own family situation is complicated. She’s close to her sister, Ava, but their mother, Avril, is cold and judgmental. In the present, Quinn confides in Ava about her feelings but doesn’t share them with Graham; this drives a wedge between the couple. One night during lovemaking, Graham becomes upset when he realizes Quinn is only interested in sex because she’s ovulating; he refuses to finish inside of her. Quinn reacts to this by weeping, which sparks a long period of the couple not having sex. Quinn’s sister Ava moves to Europe with her husband and soon becomes pregnant herself. Quinn mourns the ease with which other women are able to get pregnant, but is also genuinely happy for her sister.

The tension in the couple’s sex life “Now” is vastly different from their intense physical chemistry “Then.” Flashbacks show Quinn and Graham as sexually compatible and active. The novel draws an interesting parallel using this method, as “Then” Quinn and Graham discuss how to weather what they call “Category 5” moments in a marriage. Their younger selves are confident that they’ll be able to get through anything together, while their older selves struggle to connect and find the same closeness. In the past, Graham eventually meets Quinn’s mother, Avril. Quinn is worried that Graham will judge her based on her cold mother, but Graham says that seeing where she came from makes him admire her even more.

In the present, Quinn and Graham begin to lie to each other. Quinn sees Graham holding his newborn nephew and overhears him telling his sister that he’s devastated they haven’t had a child yet; grief-struck, Quinn leaves and pretends as though she never arrived in the first place, claiming traffic prevented her from visiting her sister-in-law. When he returns home, Graham lies and tells Quinn that he didn’t get to hold his baby nephew. Graham comes home drunk one evening and initiates sex. Quinn, who’d been oddly relieved by the removal of sex from their lives, belatedly counts the days of her cycle to see if she’s ovulating. Graham objects to her lack of sexual response, saying it feels like he’s “making love to a corpse” (139). Quinn begins to suspect that Graham is having an affair. She confronts him, and he confirms it. Quinn is devastated and angry, packing a bag and driving to her mother’s house, intending to stay there—but instead has a conversation with Avril. They discuss Avril’s lack of interest in having children. Avril says she didn’t originally want children but is grateful for Quinn and Ava. Quinn feels better and goes home.

Graham explains that his affair consisted only of kissing. He says he thinks he did it because the woman, Andrea, reminded him of Quinn. That night in bed, Quinn experiences intense stomach pain and begins bleeding. Graham takes her to the hospital, where they discover that Quinn had a rare type of nonviable pregnancy—a cervical ectopic pregnancy—and has miscarried. The hemorrhaging is so severe that the doctors perform a hysterectomy, removing any hope the couple has of conceiving naturally. Quinn grieves, but reassures Graham that he isn’t to blame for the situation. When Ava plans to fly back to the United States to be with Quinn, Quinn decides to fly to Europe instead. She stays with Ava for several weeks, relieved and happy to be away from her marital heartbreak; she doesn’t talk to Graham during this time. One day, Graham shows up unannounced at Ava’s door. He’s brought a wooden box with him and demands that Quinn make a decision about their marriage. Inside the box are love letters they wrote each other early in their marriage—they’d agreed to open these letters either on their 25th wedding anniversary or in case of a marital emergency. Quinn notices that Graham wrote her additional letters over the years; each one addresses the growing rift in their marriage and expresses understanding of Quinn’s pain. She is deeply moved by the letters and weeps; Graham holds her. Quinn tells Graham that she loves him and wants to stay together. The couple decides to move to Italy for a few years to be near Ava.

The Epilogue takes place two years in the future, when Quinn and Graham are shopping for their nephew’s second birthday. When asked if they’re shopping for their own child, they spin an elaborate lie about their six daughters; this is a game they started playing to cope with intrusive questions. In another store, Quinn finds a puppy. The couple adopt it and name it August, after the numbers on the back of their fortune cookies and the date of their anniversary.