All Your Perfects confronts the sensitive issue of infertility in marriage. Quinn and Graham are a conventionally attractive and successful couple who are deeply in love. Societal expectations dictate that they should have children; this is something both Quinn and Graham want, but biological and legal obstacles prevent it from happening. Quinn’s inability to conceive makes her feel like she’s failed as a woman: “[I]nside, I am not at all attractive. I am not internally appealing by Mother Nature’s standards, because I do not have a working reproductive system” (32). She describes herself as “the break” in “a beautiful circle” of “birth, life, and death,” saying she’s “standing on the outside of the circle of life, watching the world spin while I am at a standstill” (32). Her shame and guilt spread to the physical and sexual aspects of her marriage: She finds herself unable to separate sex from the purpose of conception, so the repeated disappointment of failing to conceive eats away at her ability to enjoy physical intimacy for its own sake.

The novel highlights the ways in which insensitive people can worsen the experience of infertility through casual, well-intentioned questions. As a young married couple, Quinn and Graham are often asked when they’re going to have children.