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January has Garnet as it's traditional birthstone.  Garnets are readily available in most sizes, colors,  and price ranges, so there is little reason to use any other gem for this month.  Rose Quartz is sometimes used as a substitute.

Amethyst is the gem of choice for February and like Garnet, it comes in all sizes and is usually reasonably priced.  Amethyst ranges in color from dark richly saturated purple to pale almost colorless violet.  Alternate: Onyx

Aquamarine is the blue-green gemstone for March.  It's subtle liquid beauty is contrasted in it's more masculine alternate, Bloodstone. Bloodstone is rich green with flecks of bright red dappled throughout the stone.

April is the month of months with Diamond as it's birthstone.  Diamonds come in every color, but it is traditional to use the colorless variety in a birthstone setting.  Alternates include white sapphire and rock crystal.

May is the month for Emerald, the deep green cousin of March's birthstone Aquamarine.  Popular substitutes include Chrysoprase,  green agate, or jasper.

June is the least clearly defined of any of the months with Pearls, Alexandrite, and Moonstone all having strong followings.  Pearl is probably the leader and is a valuable addition to any jewelry collection.

Ruby is the red hot gem for July.  Ruby is one of the rarest precious gems and a fine stone would be a treasure for generations.  A less expensive alternative is Carnelian.

Peridot takes the spot for August.  The "Sprite bottle" green of  Peridot has enchanted generations of jewelry lovers.  The beautiful translucence of Jade makes it a wonderful alternative.

Sapphire, particularly in blue, is Septembers birthstone.  It's durability makes it a great choice for men or women.  Lapis Lazuli is another traditional stone for this month.

Opal has a fascinating history as a birthstone.  A few people have heard that it is unlucky to wear Opals if it is not your birthstone.  And some have heard that it stems from a Victorian novel, but really Opal has been waxing and waning in popularity since the time of the Romans!  While it's magical powers may be debatable, it's beauty isn't.  If there's any doubt, pink tourmaline or zircon would be safe alternatives.

Citrine has probably replaced Topaz as the most common birthstone for November.  The rich affordable Citrine is available in very large sizes and makes a wonderful statement in a modern piece of jewelry.

Another toss-up in December, this month shares it's honors among Tanzanite, Blue Topaz, and Turquoise. Blue Zircon was an alternative that has fallen out of use as the others are more in vogue now.