I just decided to create a truly unique ring for my SWMBO.
It's a petawatt laser titanium-doped sapphire rod, cut into a cushion-cut gemstone, with two diamond pears in a subtle platinum setting and ring.
My thoughts:
Lots of little diamonds around something a a fad. Most current ring styles and diamond cuts are a fad, diamonds are a HUGE ripoff, and the classics (cut, settings, etc) never go out of style.
Don't get into the one-up mindset, and try to seek her thoughts in terms of what she likes.
Colored stones can be good or bad. The red center stone in mine matches well with her other ring (garnet in a silver setting) and the bracelet I got her (silver with diamonds), so that worked for me.
The key is something unique, but not weird. If its not unique in design (and unique can be subtle!), and all women like unique, the uniqueness has to be size (see aforementioned ripoff).
Also, don't be afraid of custom, the incremental cost for a custom ring or setting is minimal relative to the metal (except with silver), and even unique cuts arent that expensive.