The best replacement for cultured pearls is freshwater pearls.

The best alternatives to cultured pearls are rated as following:
★★★★★  freshwater pearls
★★★★  freshwater
★★★  real pearls
★★  natural pearls
★★  natural
★  akoya
★  synthetic pearls
  simulated pearls
  tahitian
  imitation pearls
  fresh water pearls

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