Almost all freshwater pearls in the world wide market today are fresh water culture pearls from China. They are generally less expensive than similar sized Cultured pearls that are grown in Saltwater, but not always. There are effectively no natural pearls on the market, and there have not been many on the world wide market for at least the last 100 years.
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Cultured Akoya Pearls is just a type of cultured pearls. Today, almost all pearls used for jewelry are cultured by planting a core or nucleus of pearl oysters. The pearls are usually harvested after one year for akoya, 2-4 years for Tahitian and South Sea, and 2-7 years for freshwater. So basically it depends on how long it has been cultured. Look here for more examples http://www.pearlnecklacesource.com/categories/Cultured-Akoya-Pearls/
The main difference between saltwater pearls and freshwater pearls (besides the obvious salt vs fresh water) is that saltwater pearls are cultured with a bead nucleus plus a piece of mantle tissue, whereas freshwater pearls are generally cultured with only a piece of mantel tissue.
Saltwater pearls also tend to be more round, thanks to their bead nucleus.