Does your ad have to directly relate to your keywords? Stupid question I know but maybe this is something I've overlooked.
I have two ad groups with about 10 keywords each, 3-4 words (long tail) and set to match exact phrase ("xxx xxx xxx") Each phrase has the magic keyword in it (xxxx) so somewhere in my ad I put something relevant to it like- (obvious example) Lose 21 lbs in 3 weeks Get rid of your fat quick! something something xxxx something
Why don't you put your main keyword in the headline,you can easily improve your CTR with only that one move. So if you have targeted let's say "weight loss" keyword put it in the headline. Example: Proven weight loss diet. Lose 21 lbs every 3 weeks. Try this proven diet today!